Medical Biller

Cynet Systems•Mason, OH

About The Position

The Medical Biller is responsible for reviewing medical claims, transmitting them to insurance carriers, and managing the payment and denial process within the practice's electronic health records (EHR) system. This role involves monitoring claim statuses, researching open balances, and serving as the primary contact for all vision and medical claims within the practice. The goal is to maximize the claim collection rate and ensure accurate financial processing.

Requirements

High school diploma.
3+ years of related work experience.
Experience with medical billing and coding.
Ability to prioritize handling of issues.
Organization skills and ability to multitask.
Strong verbal and written communication skills.
Medical Billing.
Medical Coding.
Electronic Health Records (EHR).
Clearing House Operations.
Claim Adjudication.
Aging Reports.
Insurance Carrier Portals.

Nice To Haves

Experience working in multiple doctor practices.
Experience working with multiple insurance carriers and an understanding of their claim requirements.
Proven ability to identify issues and solve problems.

Responsibilities

Review medical claims and transmit to the insurance carrier using the practice electronic health records (EHR) system and clearing house.
Monitor rejected claim reports and adjust claims for resubmission to the insurance carrier.
Download insurance carrier explanation of payments (EOPs) to post claim payments and denials in the EHR system.
Determine if denied claims can be corrected and re-submitted to the carrier.
Review aging reports to research open balances and resubmit within insurance carrier filing limits.
Utilize insurance carrier websites and contact carriers as needed to investigate denials and claim status.
Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system.
Initiate overpayment refunds to patients and repayments to insurance carriers when required.
Serve as the point of contact for the practice regarding all vision and medical claims.
Support the corporate manager in maximizing claim collection rate.
Monitor insurance carrier adjudication of medical claims for one or more doctor practices.
Utilize a practice EHR system and clearing house to review and submit claims to multiple medical insurance carriers.
Review open/unpaid claim balances and take required action.