Responsible for accurately processing patient billing, managing insurance claims, and ensuring timely reimbursement. This role includes reviewing medical records, coding procedures, and collaborating with healthcare providers and insurance companies to resolve discrepancies.
- Verifies insurance benefits and confirms patient eligibility
- Obtains prior authorization for services as required
- Reviews clinician-entered charges for accuracy before generating claims
- Prepares and submits claim files
- Posts insurance and client payments accurately and in a timely manner
- Analyzes and addresses ERA/EOB denials by taking appropriate corrective action
- Manages accounts receivable and actively pursues outstanding balances
- Oversees client collections to ensure timely payment
- Handles insurance appeals for denied or underpaid claims
- Stays informed and compliant with payer reimbursement policies, procedures, and guidelines
- Monitors and applies contracted fee schedules to ensure accurate expected payment
- Fosters positive communication and relationships with patients, clinicians, physicians, third-party payors, and other staff to ensure exceptional customer service
- Adheres to company policies and procedures, as well as applicable regulations, laws, and accreditation or licensure requirements
- Other duties as assigned
- No supervisory responsibilities
Requirements & Qualifications
- High school diploma required; college coursework preferred
- 1-3 years of experience in medical billing and collections, as well as insurance verification preferred
- Proficiency in Microsoft 365
- Medical coding certification preferred
- Driver's license and insurable driving record, if applicable
- Strong oral and written communication skills
- Professionalism and organizational skills
- Ability to stay focused and prioritize multiple tasks
- Computer skills and professional phone etiquette
Location
Ohio, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
2 months ago