Responsible for managing complex billing functions, ensuring timely and accurate claims processing, and resolving issues related to insurance payments and account balances. Serves as the primary contact for insurance companies and other payers, performs in-depth research to facilitate claim resolution, supports team training, assists with audits, and helps ensure compliance with payer regulations and company policies.
- Serves as the primary point of contact for insurance companies, payers, and patients regarding billing inquiries and claim resolution.
- Reviews and processes insurance claims, ensuring timely submission and compliance with payer guidelines.
- Identifies and resolves credit balances, reclassifies revenue, and processes adjustments according to transaction coding policies.
- Reviews and corrects claim filing edits in EHR and practice management systems such as Athena, Cerner, and Ingenious Med.
- Researches and resolves claim denials and rejections, identifies trends, and implements corrective actions.
- Monitors vendor and payer audit trails, submits secondary claims, and addresses discrepancies as needed.
- Maintains current knowledge of federal, state, and payer billing guidelines.
- Assists in training staff and providers on billing updates and maintains a centralized electronic repository of reference materials.
- Ensures proper billing and collection procedures in collaboration with management, clinic staff, and coding teams.
- Maintains confidentiality and complies with HIPAA regulations and company policies.
Requirements & Qualifications
- 2-4 years of experience in medical billing, insurance claims processing, or revenue cycle management.
- 1-3 years of experience in collections, third-party billing, and insurance reimbursement.
- 0-1 years of experience with Medicare preferred.
- Advanced knowledge of medical billing processes, insurance claim procedures, and payer policies.
- Strong understanding of revenue cycle management, including insurance reimbursement and claim adjudication.
- Proficiency in electronic health records (EHR) and practice management systems.
- Ability to analyze and resolve complex billing issues, including denials and payment discrepancies.
- Strong communication and problem-solving skills.
- Ability to train and mentor team members on billing best practices.
- Detail-oriented with the ability to meet deadlines and manage multiple priorities.
- Working knowledge of HIPAA regulations and data confidentiality requirements.
- CPB (Certified Medical Biller) issued by AAPC preferred or CMIS (Certified Medical Insurance Specialist) issued by PMI preferred.
Location
Alabama, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
2 months ago
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