Medical Billing Representative

Medloop a large multi-specialty medical billing company servicing many clients across the US mostly in NY/NJ is looking for a talented and highly motivated Medical Billing Representative to resolve billing issues and work directly with clients to identify and manage efficient billing processes for optimal A/R outcomes. They also manage a broad array of projects in relation to claims resolution, payer tracking, website access, claims status inquiries, and direct carrier contact.

• Serve as a liaison between patient, insurer, and practice
• Follow-up on patient accounts to assure claims for patient charges submitted to insurance companies are paid in a timely fashion
• Initiates prior authorization for all procedures requested by staff, providers, and or insurers.
• Prioritize and organizes all prior authorization activities
• Documents all prior authorization activities and record activity
• Excellent communication and organizational skills with a customer service focus
• Ability to read and understand EOB’s and ERA files
• Processing appeals
• Analyze and research denials
• Knowledge of CPT and ICD
  10 coding requirements
• Previous experience in a medical industry Is required
• Understanding of refunds/take-backs
• Knowledge of medical terminology
• Must have the ability to maintain confidential information
• Must have the ability to multitask and take initiative
• Must be able to identify and communicate billing inconsistencies

• High school diploma, or equivalent
• 2 years of medical billing experience, or medical billing training, or other experience in a healthcare setting

• Working knowledge of Medicare, Medicaid, and Commercial payor claims and appeals processing requirements
• Familiar with writing appeals with successful outcomes
• General knowledge of ICD-10, CPT-4, and HCPC coding and CCI edits
• Ability to prioritize effectively and handle shifting priorities
• Self-starter with the ability to organize work for maximum efficiency and attention to quality

At Medloop we offer great opportunities with the potential for growth.