Performs duties necessary to facilitate payment from third-party payers, including correct billing, status tracking, collections, payment posting, reimbursement calculations, and correspondence handling.
This onsite role supports multiple entities and works to ensure accurate reimbursement, compliant claims processing, and effective resolution of accounts receivable issues. The position requires working knowledge of current contracts, government regulations, payer specifications, and revenue cycle systems.
Requirements & Qualifications
Qualifications
- High school diploma or GED required
- Associate degree in business or finance preferred, or equivalent experience in medical billing, receivables, or collections
- Strong computer and general office equipment knowledge required
- Knowledge of medical terminology, ICD-9, CPT-4 coding, national billing forms, third-party payers, managed care, reimbursement, and regulatory compliance preferred
- Ability to type 45 words per minute
- Effective communication skills with patients, customers, and coworkers
- Ability to analyze communication style and respond appropriately to verbal inquiries
- Must successfully pass EUPA for all Epic applications associated with the position within the first 90 days
Responsibilities
- Ensure claims comply with payer specifications and state, federal, and HIPAA regulations
- Resolve billing issues to improve reimbursement and reduce rejections and follow-up work
- Prepare documentation to maximize reimbursement
- Analyze CPT-4, ICD-9, UB-04, HCFA 1500, and charges for accuracy
- Process third-party and internal information requests and rejections to resolve accounts receivable
- Handle third-party liabilities, outstanding credits, and unbilled accounts
- Make posting, adjustments, and refunds as needed
- Apply current contracts and government regulations appropriately
- Use multiple internal and external systems, including STAR, EC2000, EPIC, SSI, and GLMI Home Health Billing
- Verify insurance eligibility using automated online systems
Location
Michigan, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 week ago