Medical Biller

Company: US Main
Location: Racine
Posted on: April 12, 2025

Job Description:

MEDICAL BILLER

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Job Description

Responsible for the accurate preparation and submission of electronic and paper claims to appropriate parties. Monitor, timely resolve, and resubmit any insurance claims that are returned unpaid. Apply payments to patient accounts. Compile documentation and submit coding and or billing and monitor their activities as defined. Conduct appropriate research and timely respond to inquiries regarding patient account activity in accordance with written policy/procedures. Interview and counsel patients regarding financial matters related to their accounts. Research and reconcile patient accounts. Monitors and reviews the aged receivable reports to maintain correct balances due from patients or third parties.

Submits electronic insurance claims daily.
Prepares and submits paper claims as appropriate.
Post payments to patients' accounts.
Reconcile patients' accounts and recommend adjustments as appropriate.
Performs audit of claims in accordance with policy/procedure.
Monitors coding and/or billing to assure prompt preparation and submission of claims.
Monitors status of unbilled and unpaid claims and reports to management.
Provides daily/weekly/monthly reports to management.
Conducts appropriate claims tracking and resolution.
Monitors reimbursement to ensure accurate claims payment; conducts analysis and research to appropriately appeal denied claims; ensures appeals are filled timely; assumes responsibility for conducting the appeals process when required
Provide reports to management of denied/rejected claims and reasons
Maintain payer communications file; responds to inquiries from payers and patients regarding insurance claims status; submits appropriate rebilling.
Works in other areas assigned
Perform other duties as assigned

Required Skills

Accurate data entry skills with knowledge of basic keyboarding.
10-key calculator by touch.
Proficient in Microsoft Office Suite.
Excellent oral and written communication skills.
Clerical and analytical ability to be self-sufficient in performing duties and maintaining confidential records.
Knowledge of and experience with automated billing systems.
Appropriate people skills to interact with patients, physicians, third party payers and co-workers.
Knowledge of third party insurance requirements.
Knowledge of CPT and ICD-9/ICD-10 coding and the ability to monitor billing activity.
Knowledge of Federal, State and other billing regulations and guidelines.

Required Experience

College coursework or Degree required; A minimum of 2-5 years of related experience in medical and/or insurance billing is required. Medical coding experience preferred. Experience must include identification of appeal opportunities, pre-bill edit review; preparation of appropriate appeals correspondence for re-submission of claims; review of claims; review of claim form that includes place/date of service, valid HCPC, CPT, ICD10 codes; claims resolution through appropriate follow-up techniques.

Job Type: Full-time

Keywords: US Main, Chicago , Medical Biller, Healthcare , Racine, Illinois