Medical Biller / Aging Specialist

Viva Pediatrics•Richardson, TX

6d•Onsite

About The Position

We are seeking a Medical Biller / Aging Specialist to support the day-to-day management of accounts receivable and insurance claims for VIVA Pediatrics. This full-time role is responsible for monitoring claim aging, researching and resolving unpaid claims, managing denials and rejections, submitting appeals and corrected claims, and ensuring claims are billed accurately and timely. The Medical Biller / Aging Specialist works closely with the Billing Manager to maintain accounts receivable standards, resolve claim issues, identify root causes of billing problems, and help keep outstanding claims within established billing cycle timeframes.

Requirements

Two years of Accounts Receivable experience preferred
Healthcare billing or healthcare industry experience preferred
Bachelor's degree in Business Administration preferred
Knowledge of Medicaid and commercial insurance carriers
Ability to read and understand Explanation of Benefits (EOBs)
Strong analytical and problem-solving skills
High attention to detail and accuracy
Strong organizational and time-management skills
Ability to manage multiple assignments concurrently and establish appropriate timeframes
Strong verbal and written communication skills
Ability to troubleshoot billing issues and recommend effective solutions
Ability to work collaboratively with team members across the organization
Dependable and able to consistently meet deadlines
Proficient in Microsoft Office
Ability to follow established policies and procedures

Responsibilities

Follow up daily on assigned insurance claims and claim reports
Monitor accounts receivable aging and work assigned claims to help keep aging below 90 days
Research claims and refile or appeal claims as necessary by phone, paper, or online
Review and audit client accounts to determine whether claims were billed correctly
Monitor payer rejections and denials, research the cause, and reprocess claims as necessary
Research and resolve unpaid claims within standard billing cycle timeframes
Submit timely appeals for denied claims
Assist with claim resubmission projects as needed
Work with the Billing Manager to identify denial trends and streamline billing procedures
Ensure claims are billed accurately and within required timeframes
Identify and correct claim errors on a daily basis
Review partial and underpayments and maintain accurate tracking for claim resubmission and follow-up
Handle correspondence from insurance carriers, including denials and requests for additional information
Verify insurance eligibility and benefits for assigned clients
Identify and bill secondary and tertiary insurance coverage when applicable
Answer patient and insurance telephone inquiries related to assigned accounts
Ensure account write-offs are properly documented and approved by management
Maintain accurate documentation and follow established billing policies and procedures
Identify billing issues and recommend root-cause solutions
Perform other duties as assigned