Claims Representative

Mid Atlantic Retina•Whitemarsh Township, PA

20h

About The Position

The Claims Representative is responsible for submitting both electronic and paper claims to insurance companies. This position ensures that all accounts are billed appropriately and meet all regulatory and compliance requirements. The Claims Representative is also responsible for reviewing daily claim edit reports and working with other departments to resolve the claim edits.

Requirements

3-5 years medical billing experience in a physician practice or third-party billing company preferred
Previous experience with claims processing and working with a clearinghouse.
Experience with CPT, ICD10 and Microsoft Office Suite required.

Responsibilities

Pulls daily Claim Edit report from Nextgen to review red edits for errors.
Collaborates with Front Desk and Clinic to correct errors.
Submits corrected report through clearinghouse via EDI file or uploading.
Complete paper claims by reviewing account, attaching needed information, and mailing out to responsible payer.
Ensures correct processing of all accounts.
Acts as customer service representative in person and by telephone. Promptly responds to patient and corresponding payor questions regarding accounts.
Maintains up to date billing knowledge of insurance carriers to act as a resource for other departments within MAR.
Attends regular staff meetings.
Works overtime as needed.
Travels to other MAR locations as needed.
Performs other duties as assigned.