Medical Biller

Responsibilities:

• Follow and adhere to all regulations and guidelines set by state programs such as HIPAA, CMS, Medicaid, OIG, etc.
• Confirm patient demographics such as Name, Address, DOB.
• Confirm benefits and insurance eligibility.
• Confirm insurance referral/ authorization.
• Responsible for ensuring all services are assigned with the correct CPT, HCPCS and ICD-10-CM codes.
• Responsible for ensuring all services are billed and processed in accordance with government and third-party payer guidelines in a timely manner.
• Responsible for correcting, completing and processing claims for all payers.
• Review submitted claims daily for accuracy.
• Coordinate and clarify with other departments, when necessary, on information that seems incomplete or is lacking for proper coding, documentation, and/or claim adjudication.
• Review daily claim rejections and correct for resubmission.
• Other Billing Department duties as assigned and in support of departmental sub-divisions.
• You'd primarily be supporting the Cardiac and Ortho departments.
• Billing for the devices themselves in the ortho space, in cardiac billing for both telemedicine and device
• Most prevalent denials:
  • patients not covered
  • medical necessity

Skills & Qualifications:

• Typing Skills: 60-70 WPM.
• Strong computer knowledge (Microsoft Suite Programs).
• Ability to work in a fast-paced environment.
• Ability to operate multiple systems for better efficiency.
• Proficient in time management.
• Knowledge of medical terminology, cardiology coding, HCPCS, ICD-10, office billing forms, insurance and governmental payer regulations and other third-party billing requirements preferred.
• Ability to work as a team.
• Punctual on deadlines given by supervisor/sales to ensure timely delivery.
• Ability to communicate with other departments of daily updates (intake/data/customer service/sales).
• The ability to implement daily tasks based on company policies and procedures.
• Proficient in time management.