Medical Billing Representative

TridentCare•Horsham Township, PA

11d•$16 - $19

About The Position

The Medical Billing Representative reviews and evaluates medical claims to confirm patient identity, verify the examinations performed and the ordering physician or non-physician practitioner, and ensure that documents on file substantiate the service. The role includes checking patient and insurance information, obtaining missing information from clients, and contacting insurance companies for pre-authorizations. The representative maintains current knowledge of applicable guidelines and federal regulations using CPT books, ICD-10 materials, the Federal Register, and other relevant resources. The role cross-trains across five billing work queues, participates in department meetings, and may perform other tasks assigned to support organizational goals. Overtime is required as needed to meet departmental goals.

Responsibilities

Review ETech Logs for accuracy of patients seen.
Review Manual Tech Logs and ETech Logs for accuracy of patients seen by technicians on a 90-day probation.
Verify designated fields on patient claims by reviewing information in the medical record.
Update patient and insurance information as necessary.
Contact clients directly to obtain critical missing information as needed.
Contact insurance companies to obtain pre-authorizations as needed.
Maintain current knowledge of guidelines and relevant federal regulations using current CPT books, ICD-10 materials, the Federal Register, and other pertinent materials.
Cross-train in the five billing work queues: MBI Medicare, Missing Payor, Billing, Dr Mobilex, and MBI Replacement Plan.
Attend and participate in department meetings.
Work required overtime as needed to meet departmental goals.
Perform other tasks as assigned to support organizational goals.