Job description
Job Summary
With limited supervision, this position is responsible for the accurate submission of all charges and claims as assigned and required to bring issue/problem identification and investigation through to an accepted/successful resolution.
This Senior Physician Billing Associate will be responsible for:
With limited supervision, this position is responsible for the accurate submission of all charges and claims as assigned and required to bring issue/problem identification and investigation through to an accepted/successful resolution.
This Senior Physician Billing Associate will be responsible for:
- Engaging patients or guarantors to resolve billing issues or guarantor responsibility as needed. Responding to inquiries received via telephone and other correspondence for patients/guarantors, insurance carriers, departments/foundations as needed
- Reviewing and verifying all demographic and insurance information utilizing available technologies, payer websites, or by phone contact with third party payers or guarantors
- Collaborating with management and peers to ensure all required information is obtained for resolution of charge edits, claim edits, denials, and appeals in a timely manner, while adhering to government/payer regulation and department policy/procedures
- Preparing and submitting accurate insurance claims and appeals to payer within required timeframes and in accordance with government/payer regulations and requirements
- Resolving outstanding charges and claims responding timely and accurately for resolution of outstanding balance while adhering to department policies/procedures
- Accepting, rejecting, and reconciling claim runs on timely basis and processes payer response reports in an effective and timely manner
- Reviewing and processing guarantor overpayments per department policies and procedures
- Responding to inquiries received via telephone and other correspondence from patients/guarantors, insurance carriers, departments/foundations as needed
- Assisting with the training of newly hired staff in process and system navigation
- High School diploma or equivalent and a minimum of 2 years of experience in a multi-specialty physician billing or equivalent medical billing experience
- Position is on the Registration and Claims team
- Attention to detail, good organizational skills, ability to meet priorities within set timeframes, and ability to work as part of a team
- Comprehensive ability and knowledge of electronic claims processing, electronic remittance advice, electronic payment posting, and clearinghouse functions
- Thorough knowledge and understanding of benefits and/or coverage as indicated by third-party payer requirements
- Knowledge of insurance authorizations in relation to medical billing
- Hybrid/Remote if you live in MA, RI, NH or ME
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