Medical Claims Biller Onsite

The Medical Claims Biller is responsible for monitoring insurance carrier adjudication of medical claims for one or more doctor practices. Utilize a practice EHR system and clearing house to review and submit claims to multiple medical insurance carriers. Review open/unpaid claim balances and take required action.

BASIC QUALIFICATIONS

• High school diploma

• 3 years of related work experience

• Experience with medical billing and coding

• Ability to prioritize handling of issues

• Organization skills and ability to multitask

• Effective communication skills (verbal written listening presentation)

• Experience working in multiple doctor practices

• Experience working with multiple insurance carriers and an understanding of their claim requirements

• Proven ability to identify issues and solve problems

MAJOR DUTIES & RESPONSIBILITIES

• Review medical claims and transmit to the insurance carrier using the practice electronic health records (EHR) system and clearing house.

• Monitor rejected claim reports and adjust claims for resubmission to the insurance carrier.

• Download insurance carrier explanation of payments (EOPs) to post claim payments and denials in the EHR system.

• Determine if denied claims can be corrected and re-submitted to the carrier.

• Review aging reports to research open balances and resubmit within insurance carrier filing limits.

• Utilize insurance carrier websites and contact carriers as needed to investigate denials and claim status.

• Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system.

• Initiate overpayment refunds to patients and repayments to insurance carriers when required.

• Serve as the point of contact for the practice regarding all vision and medical claims.

• Support the corporate manager in maximizing claim collection rate.