Insurance Follow Up​/ Medical Biller

Qualifications

• Minimum 2-3 years of experience in medical billing.
• Must be able to communicate effectively with physicians, patients, and the public, and be capable of establishing good working relationships with both internal and external customers.
• High School Diploma/GED.

• Knowledge of computer systems, including experience with GE patient management system.
• Knowledge of physician billing processes, ICD-10, and CPT coding.

• Reviews insurance denials and rejections to determine the next appropriate action steps and obtain the necessary information to resolve any outstanding denials/rejections.
• Verifies patient demographic information and insurance eligibility, including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.
• Verifies receipt of claim with insurance plans, determining the next appropriate action steps and timeliness of claims maximum reimbursement.
• Researches all information needed to complete the billing process, including obtaining information from providers, ancillary services staff, and patients.
• Obtains and attaches referrals/authorizations to appointments/charges.
• Maintains productivity and accuracy metrics per department expectations and AEIOU Behavioral Standards.
• Assumes full responsibility for reducing the accounts receivable of insurance balances by working through outstanding accounts.
• Analyzes account for proper claims processing and payment posting through inquiries from patients or staff.
• Identifies and communicates trends and/or potential issues to the management team.
• Follows and maintains all HOPCo policies and procedures, including those specific to billing and the Revenue Cycle.

Equal Opportunity Employer

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