Summary of Duties: Reviews and resolvesunpaid claims, resubmits claims as necessary, prepares take-backs, works denials and addresses various billing issues with third party payers and patients.
Classification:Full-Time /Hourly / Non-Exempt
Supervision Received: Reports to Billing Manager.
- Performs a thorough and consistent research of and follows up on accounts with outstanding claims using periodic and regular aging reports.
- Contacts the patient and/or third party payer as appropriate.
- Prepares appeals via appropriate means according to carrier guidelines for all claims that require reconsideration for appropriate or additional payment.
- Identifies and re-assigns financial responsibility as appropriate. Evaluates patient’s financial status and establishes budget payment plans as needed.
- Prepares and approves statements for services that become the patient’s responsibility.
- Performs various collection actions as necessary.
- Documents all activity taken in each patient’s account.
- Processes all non-payment correspondence, underpayments, or overpayments.
- Participates in educational activities. Attendsregular team meetings and all company-wide meetings.
- Maintains knowledge of multiple practice management systems that MedComm uses to manage the revenue cycle process for its clients.
- Conducts self in accordance with MedComm’s employee manual.
- Maintains strictest confidentiality and adheres to all compliance regulations.
- Assists MedComm by supporting all contractual timelines as outlined in the Billing Service Agreement for each assigned client.
- Accepts and completes other duties as assigned by Team Lead or Billing Manager.
Associate or bachelors degree in business or related field is preferred.
- Three (3) years previous medical billing experience required.
- Knowledge of CPT and ICD coding required.
- Charge/payment entry experience required.
- Ability to read and understand an EOB required.
- Ability to research an account and identify actual and potential causes for payment delays. Understanding of correct steps needed to resolve delays.
- Must have excellent oral communication skills.
- Must be well organized and detail-oriented.
- Experience with Microsoft Outlook, Excel and Word.
- Knowledge of business office equipment and common procedures.
Environmental/Working Conditions: Normal office environment. Occasional overtime may be required as business needs dictate.
Physical Demands: Requires sitting and standing associated with a normal office environment. Manual dexterity needed for using a telephone and computer keyboard.