Job Description:
A highly motivated professional with knowledge and/or experience in medical office billing. Previous health care billing experience for physicians/outpatient services or claims processing for insurance companies is required. The ideal candidate will have medical or Multi-specialty billing experience, knowledge in payment posting, medical necessity requirements, coordination of benefits, refund processing, customer service, or claim appeals. Requires strong data entry skills and attention to detail.
Responsibilities:
- Initiates timely collection and disposition of unpaid claims including all denials, appeals, and secondary coverage with the appropriate insurance carrier
- Researches and resolves underpayments with insurance carrier as per billing contract
- Contacting patients regarding balances, outstanding claims, and assisting with denials if necessary
- Updating patient demographics by utilizing third party payer on-line resources to verify insurance benefits, coordination of benefits, check claim status, and file corrected claims directly with payer if required
- Process all credit balances and refund requests to insurance companies and patients
- Performs contractual adjustments with supporting documentation with administrative approval
- Performs other duties or special projects as assigned by manager
- Maintain confidentiality of all patient privacy and policy information
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