Medical Billers Managed Care

Job Summary

The role is responsible for submitting editing correcting and researching claims to ensure clean adjudication payment from all payors.

What Would You Do The Specifics.

• Prepares and generates clean claims for submission to all payor types including third-party payors Medicare and Medicaid. Submissions of claims to be are done via 837 electronic CMS-1500 fax and online web portal.
• Processes an average of 20-25 claims per hour.
• Facilitates all rejections from electronic or paper claims. Obtains information from carriers stores internal entities or patients when services billed are denied for reasons such as incorrect insurance information demographic information and/or authorization. Appeals denials when necessary.
• Develops and maintains working relationships with internal/external providers to ensure billing and collections procedures are current.
• Researches and resolves all zero payment explanations or benefits and exercises all options to obtain claims payments; initiates adjustments as necessary.

Qualifications :

Work Experience

• 2-4 years medical billing experience (Required)
• Knowledge of CPT-4 ICD10 HCPCS Medicare/Medical Terminology (Required)

Education

• High school plus specialized schooling and/or on-the-job education in a specific skill area; E.G. data processing clerical/administrative equipment operation etc. (Required)

Additional Skills

• POS System experience preferred.

People Management

• Individual Contributor

Additional Information :

Taking Care of our People!

We understand the importance of financial health and security and because of that we provide competitive compensation to all Associates. We also offer a comprehensive benefits package including health and dental insurance 401k retirement savings with company match flex spending account paid personal time off paid company holidays parental leave employee eyewear discount and much much more. At National Vision we strive to deliver opportunities for professional growth and long-term career fulfillment. We provide training programs and access to educational courses and pride ourselves on the ever-increasing amount of promotions from within.

#LI-SH1

We are an equal opportunity employer.  We evaluate qualified applicants without regard to race color religion sex sexual orientation gender identity national origin genetic information disability veteran status and other legally protected characteristics.

Remote Work :

No

Employment Type :

Full-time