Title: Medical Claims/Billing Specialist
Location: Mason OH – Hybrid 3 Days in office
Contract: 4 Months and Temp to perm
Work hours: First Shift – 8 AM – 5 PM
GENERAL FUNCTION
The Medical Claims Biller is responsible for monitoring insurance carrier adjudication of TeamVision 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.
MAJOR DUTIES & 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***
BASIC QUALIFICATIONS
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
Effective communication skills (verbal, written, listening, presentation)
PREFERRED QUALIFICATIONS
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