Medical Biller

Job Detail

Duties of Medical Biller

Obtaining referrals and pre-authorizations as required for procedures.
Checking eligibility and benefits verification for treatments, hospitalizations, and procedures.
Reviewing patient bills for accuracy and completeness, and obtaining any missing information.
Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
Following up on unpaid claims within the standard billing cycle timeframe.
Checking each insurance payment for accuracy and compliance with contract discount.
Calling insurance companies regarding any discrepancy in payments if necessary
Identifying and billing secondary or tertiary insurances.
Reviewing accounts for insurance of patient follow-up.
Researching and appealing denied claims.
Answering all patient or insurance telephone inquiries pertaining to assigned accounts.
Setting up patient payment plans and work collection accounts.
Updating billing software with rate changes.

Education and Experience Required

High school diploma, GED, or equivalent.
Experience in Medical Billing
University/college degree, or experience in medical records, claims or billing areas is an asset
Knowledge of business/accounting processes, medical terminology likely to be encountered in medical claims.
Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA)

Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
Ability to multitask.