Job Descriptions:

• Check eligibility and benefit verification.
• Review patient bills for accuracy and completeness and obtain any missing information
• Prepare, review, and transmit claims using billing software, including electronic and paper claim processing.
• Knowledge of insurance guidelines, including HMO/PPO, Medicare, and state Medicaid
• Follow up on unpaid claims within standard billing cycle timeframe
• Check each insurance payment for accuracy and compliance with contract discount
• Call insurance companies regarding any discrepancy in payments if necessary
• Identify and bill secondary or tertiary insurances
• All accounts are to be reviewed for insurance or patient follow-up
• Research and appeal denied claims.
• Answer all patient or insurance telephone inquiries pertaining to assigned accounts.
• Set up patient payment plans and work collection accounts
• Update billing software with rate changes.
• Updates cash spreadsheet, runs collection reports.

Knowledge, Skills, and Abilities

• Knowledge of Medicare, Medicaid, and other payer requirements and systems.
• Use of computer systems
• Effective communication abilities for phone contacts with insurance payers to resolve issues.
• Able to work in a team environment.
• Problem-solving skills to research and resolve discrepancies, denials, appeals, collections.
• Knowledge of medical terminology likely to be encountered in medical claims.
• Preferably have knowledge of working on different billing software's especially "Kareo" and "CureMD EMR. 
• Knowledge of business and accounting processes usually obtained from an Associates in Business Administration, Accounting or Health Care Administration preferred.