The Medical Biller is responsible for managing the administrative process of submitting insurance claims to payers on behalf of a healthcare provider. This includes verifying patient insurance coverage, preparing and submitting accurate medical bills, following up on unpaid claims, resolving billing discrepancies, and communicating with patients regarding outstanding balances to help ensure timely payments for medical services rendered.
Responsibilities
- Create and submit electronic or paper claims to insurance companies, including accurate coding of diagnoses and procedures based on medical records.
- Check patient insurance eligibility and benefits, and obtain pre-authorizations for procedures when necessary.
- Review medical records for completeness and accuracy to ensure proper billing.
- Monitor claim status, contact insurance companies to resolve denials or billing issues, and initiate appeals when necessary.
- Explain patient bills, address billing inquiries, and set up payment plans for outstanding balances.
- Maintain patient demographic information and billing records within electronic health records (EHR) systems.
- Adhere to HIPAA regulations and stay updated on healthcare billing guidelines and coding practices.
- Perform other duties as assigned.
Tools and Systems
- Medical billing software
- Awards EHR system
- Excel
- Optum Medical Network Solutions / Claims Clearinghouse
Proficiency in medical billing software and electronic health record (EHR) systems.
Strong knowledge of medical coding and medical collection processes.
Excellent attention to detail with strong organizational skills and the ability to work effectively with patients and insurance representatives.
Associate degree in a related field preferred, or 5 years of medical billing work experience.
Location
New York, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago