Experienced Medical Biller - Claims & Revenue Cycle

Experienced Medical Biller - Claims & Revenue Cycle

Description

Location:
In-Office

Position Type:
Full Time

Department
:
Medical Billing/Revenue Cycle

Salary
: $18.25 to $25.00 per hour dependent on Experience

$2500.00 sign-on bonus for those who qualify

POSITION OVERVIEW:

We are seeking an experienced

Medical Biller
to join our in-office billing team
. The ideal candidate will have strong hands-on knowledge of the medical billing and revenue cycle process, and be comfortable working directly within
Change Healthcare, SSI, insurance carrier portals, and other payer systems.

This position requires someone who understand show to research, correct, update, and resubmit claims, and can also identify the underlying reason a claim has been denied or requires correction. The successful candidate must be detail-oriented, analytical, and capable of independently resolving billing issues rather than simply submitting claims.

KEY RESPONSIBILITIES:

• Review medical claims for accuracy, completeness, and payer requirements.
• Research and correct denied, rejected, suspended, and incorrectly billed claims.
• Update and correct claims through
  
  Change HealthcareandSSI portal
• Access and navigate individualinsurance carrier portalsto correct and resubmit claims
• Identify and correct claim errors involving:
  • CPT codes
  • ICD-10 diagnosis codes
  • Revenue codes
  • Modifiers
  • Units
  • Charges
  • Provider information
  • Place of service
  • Authorization information
  • Patient and insurance demographics
  • Other payer-specific requirements.
• Review claims to ensure the
  diagnosis code supports and is appropriate for the CPT code(s) billed.
• Verify that CPT and diagnosis combinations meet the payer billing requirements.
• Update and correct
  APG rates
  when applicable.
• Review and update revenue codes based on the services rendered and payer requirements.
• Investigate claim edits and payer rejections and determine the appropriate correction.
• Resubmit corrected claims through the appropriate clearinghouse or payer portal
• Monitor corrected claims to ensure they are successfully accepted and processed
• Review payer responses, claim status, EOBs, ERAs, and denial information
• Contact insurance carriers when additional research or clarification is required
• Document claim corrections, payer communications, and follow-up activity accurately.
• Identify recurring billing issues and communicate trends to management
• Maintain productivity and quality standards which ensure accuracy
• Work independently while managing assigned accounts and claim follow-up within established time frames.

BENEFITS:

• Medical/Dental/Vision coverage offered
• 401K
• Paid Time Off (Sick/Vacation/Personal)

REQUIRED EXPERIENCE & KNOWLEDGE

The ideal candidate will have
strong hands-on medical billing experience., including demonstrated experience with claim corrections and payer follow-up.

• Prior professional medical billing experience
• Strong understanding of the complete medical billing and revenue cycle process
• Experience working directly in
  Change HealthcareandSSI portals
• Experience correcting claims through insurance carrier portals
  .
• Strong knowledge of
  CPT, HCPCS, ICD-10 and revenue codes
• Understanding of medical necessity and diagnosis-to-procedure code relationships.
• Knowledge of
  APG rates
  and the ability to update or correct APG-related billing information.
• Ability to identify why a claim was rejected or denied and determine the appropriate correction.
• Experience with corrected claims and claim resubmissions.
• Ability to research payer requirements and follow payer-specific billing guidelines
• Excellent attention to detail and accuracy
• Strong organizational and follow-up skills

PREFERRED QUALIFICATIONS:

• Experience with hospital, physician, outpatient, or facility medical billing
• Experience working with high-volume claim inventories
• Experience…