Medical Biller and EVV

At Home Care Missouri • Ferguson, MO

96d

About The Position

The Medical Biller, under routine supervision, performs all duties related to preparing and submitting medical insurance claims. This position reviews and adjusts accounts to ensure appropriate claim billing, including interacting with third parties and participants, processes, research, corrects accounts, posts payments, and adjustments, and interprets Explanation of Benefits (EOB) documentation.

Requirements

• A minimum of 1 year of experience in healthcare billing or medical office settings.
• Preference for experience using Electronic Visit Verification (EVV) Homecare software.
• Ability to effectively manage workload in a high-volume environment.
• Strong attention to detail.
• Working knowledge of PC applications (Microsoft Office Suite- Excel, Word).
• Strong ability to compute percentages and basic math functions.
• Effective oral, written, and interpersonal communication skills.

Responsibilities

• Prepares and submits clean claims to various insurance companies either electronically through EMOMED or the payer portal.
• Aides in the use of the Electronic Visit Verification (EVV) system.
• Processes medical claims by a billing clearinghouse or by paper.
• Work with the Revenue Cycle Management team to address visit exceptions, post charges, and submit claims in a timely manner.
• Resolve claim denials and errors will be essential in maintaining the financial health of the organization.
• Follow up on outstanding accounts using Aging Reports, EOB's (Explanation of Benefits), and/or other correspondence, ensuring compliance with HIPAA regulations throughout the process.
• Work visit exceptions daily in software fixing the issue.
• Post charges weekly.
• Understand Medicaid, Managed Medicaid and Commercial Insurance regulations.
• Recognize and work claim denials and errors and know timely filing for each payer.
• Recognize payment errors (using payer contracted rates).
• Gathers insurance billing information by reviewing patient EVV records; checking for completeness.
• Bills carrier by inputting billing information to database; initiating electronic transmissions.
• Process claims as they are paid and credit accounts accordingly.
• Resolves disputed claims by gathering, verifying, and providing additional information; following-up on claims.
• Resolves discrepancies by examining and evaluating data; selecting corrective steps.
• Adjusts patient bills by reviewing remittance advice; consulting with payer.
• Monitor payor claim acceptance and response timeliness.
• Escalate claims for potentially payor relations bulk resolution.
• Ensure proper charge capture, billing, and adjudication of claims per federal, state, and private billing guidelines.

Benefits

• Medical, Vision, Dental and, Life insurance.
• Direct Deposit.
• Top pay wage scale.
• Paid Time off and holiday pay.
• Paid Travel.

What This Job Offers