Billing Representative

Duties And Responsibilities

• Follows up on submitted claims, monitors unpaid claims and resubmits claims with appropriate corrections and documentation.
• Reviews claim forms for the accuracy of procedures, diagnoses, demographic and insurance information, as well as all other fields on the CMS 1500.
• Submit professional appeals and re-determinations, with appropriate clinical documentation, to Commercial, Medicare, and Medicaid payers when necessary.
• Reviews and corrects all claims/charge denials and edits that are communicated via Brightree.
• Responds to patient and third-party inquiries, researches and resolves complex claims and corrects errors.
• Recognize and resolve authorizations issues with insurance payers and third-party authorization companies.
• Reviews correspondence and rejection data from insurance carriers; posts rejections and performs reconciliations.
• May transfer secondary balances to appropriate financial class and provide documentation for processing the claims.
• Receive payments through various methods (cash, online payments etc.) and check for credibility.
• Helps post cash batches and checks to individual invoices.
• Reconciles deposits and invoices posted.
• Sends reminders for payments and contact customers with balances or insurance issues.
• Updates accounting records with new payments, balances, customer information etc.
• Answer questions and handle complaints from customers regarding bills.
• Participates in accounts receivable projects.
• Participate in standing meetings as necessary.

Qualifications

• 18 years of age or older.
• Must be eligible to work in the United States and not require work authorization from us now or in the future.
• High School diploma or equivalent required; college preferred.
• At least 1 year of experience in Medical Billing or relevant experience.
• At least 1 year of experience with Brightree system.

Skills

• Great customer service skills.
• Professional computer experience (especially Microsoft Office Suite).
• Ability to work independently to investigate and make decisions.
• Strong attention to detail.
• Ability to prioritize and complete work amidst interruptions in a busy work area.
• Adapt positively to changes in the work setting with ease.
• Available during normal hours of operation.
• Ability to comply with guidelines both internal and industry-imposed.
• Working knowledge of third-party payor reimbursement.
• Knowledge of medical billing, insurance rules and regulations required.