Office/Administration - Medical Claims Coordinator/Processor
About The Position
The Medical Claims Biller monitors insurance carrier adjudication of TeamVision medical claims for one or more doctor practices. The role uses a practice electronic health records (EHR) system and a clearing house to review and submit claims to multiple medical insurance carriers, monitor unpaid balances, investigate claim denials and status, and take necessary steps to correct and resubmit claims. The position also handles payment posting, patient billing statement distribution, refunds, and practice questions about vision and medical claims, while supporting the corporate manager in maximizing claim collection rates. This is a temp-to-perm assignment supporting new business coming online. The schedule is first shift, 8 AM to 5 PM. The role is hybrid, working remotely Monday and Friday and in the office Tuesday, Wednesday, and Thursday.
Requirements
- High school diploma.
- At least 3 years of related work experience.
- Experience with medical billing and coding.
- Ability to prioritize handling of issues.
- Organization skills and ability to multitask.
- Effective verbal, written, listening, and presentation communication skills.
- The requisition specifies 5 years of experience.
Nice To Haves
- Experience working in multiple doctor practices.
- Experience working with multiple insurance carriers and understanding their claim requirements.
- Proven ability to identify issues and solve problems.
Responsibilities
- Review medical claims and transmit them to insurance carriers through the practice EHR system and clearing house.
- Monitor rejected claim reports and adjust claims for resubmission to insurance carriers.
- Download insurance carrier explanations of payments (EOPs) and post claim payments and denials in the EHR system.
- Determine whether denied claims can be corrected and resubmitted to the carrier.
- Review aging reports, research open balances, and resubmit claims within insurance carrier filing limits.
- Use 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 practice point of contact for vision and medical claims.
- Support the corporate manager in maximizing the claim collection rate.
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
