Medical Billing / AR

Randstad USA
Published
September 15, 2020
Location
Houston, TX
Category
Job Type

Description

job summary:

Medical Billing

Job Description:

Summary:

  • The main function of a medical biller is to submit medical claims to insurance companies and payers such as Medicare and Medicaid.
  • Responsible for the timely submission of technical or professional medical claims to insurance companies.
  • The position may be located in physician offices, hospitals, nursing homes, or other healthcare facilities.

Job Responsibilities:

  • Obtain referrals and pre-authorizations as required for procedures
  • Check eligibility and benefit verification Review patient bills for accuracy and completeness and obtain any missing information
  • Prepare, review, and transmit claims using billing software, including electronic and paper claim processing
  • Knowledge of insurance guidelines, including HMO/PPO, Medicare, and state Medicaid Follow up on unpaid claims within standard billing cycle timeframe Check each insurance payment for accuracy and compliance with contract discount Call insurance companies regarding any discrepancy in payments if necessary Identify and bill secondary or tertiary insurances
  • All accounts are to be reviewed for insurance or patient follow-up Research and appeal denied claims Answer all patient or insurance telephone inquiries pertaining to assigned accounts.
  • Set up patient payment plans and work collection accounts Update billing software with rate changes
  • Updates cash spreadsheet, runs collection reports

Skills:

  • Knowledge of HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
  • Use of computer systems, software, 10 key calculator Effective communication abilities for phone contacts with insurance payers to resolve issues Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds
  • Able to work in a team environment Problem-solving skills to research and resolve discrepancies, denials, appeals, collections
  • Knowledge of accounting and bookkeeping procedures
  • Knowledge of medical terminology likely to be encountered in medical claims

Education/Experience:

  • High school diploma
  • Knowledge of business and accounting processes usually obtained from an associate's degree, with a degree in Business Administration, Accounting, or Health Care Administration preferred 2 to 4 years of experience.

Required Skills:

Follow up of outstanding A/R all payers and resolution of denials.

  • Handling all correspondence related to an insurance or patient account, contacting insurance carriers, patients and other facilities as needed to get maximum payment on accounts and identify issues or changes to achieve client profitability.
  • Research and resolve accounts as directed by management making appropriate decisions on accounts to be worked to maximize reimbursement

Desired Skills

  • Understanding of the A/R process
  • Ability to verify insurance
  • Capable of meeting daily deadlines with little supervision.
  • Computer proficient (able to maneuver between multiple windows, and multi-task)
  • Analytical skills (able to identify trends)
  • Experience with review and appeal of coding based denials: non-covered, bundling, duplicates

Desired Experience:

  • 3-5 years related work experience (physician billing, collections, claims)
  • Knowledge of duplicate, no authorization and coding denials preferred

 

location: Houston, Texas

job type: Contract

work hours: 8 to 5

education: Bachelor's degree

experience: 5 Years

 

responsibilities:

Job Responsibilities:

  • Obtain referrals and pre-authorizations as required for procedures
  • Check eligibility and benefit verification Review patient bills for accuracy and completeness and obtain any missing information
  • Prepare, review, and transmit claims using billing software, including electronic and paper claim processing
  • Knowledge of insurance guidelines, including HMO/PPO, Medicare, and state Medicaid Follow up on unpaid claims within standard billing cycle timeframe Check each insurance payment for accuracy and compliance with contract discount Call insurance companies regarding any discrepancy in payments if necessary Identify and bill secondary or tertiary insurances
  • All accounts are to be reviewed for insurance or patient follow-up Research and appeal denied claims Answer all patient or insurance telephone inquiries pertaining to assigned accounts.
  • Set up patient payment plans and work collection accounts Update billing software with rate changes
  • Updates cash spreadsheet, runs collection reports

Skills:

  • Knowledge of HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
  • Use of computer systems, software, 10 key calculator Effective communication abilities for phone contacts with insurance payers to resolve issues Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds
  • Able to work in a team environment Problem-solving skills to research and resolve discrepancies, denials, appeals, collections
  • Knowledge of accounting and bookkeeping procedures
  • Knowledge of medical terminology likely to be encountered in medical claims

Education/Experience:

  • High school diploma
  • Knowledge of business and accounting processes usually obtained from an associate's degree, with a degree in Business Administration, Accounting, or Health Care Administration preferred 2 to 4 years of experience.

Required Skills:

Follow up of outstanding A/R all payers and resolution of denials.

  • Handling all correspondence related to an insurance or patient account, contacting insurance carriers, patients and other facilities as needed to get maximum payment on accounts and identify issues or changes to achieve client profitability.
  • Research and resolve accounts as directed by management making appropriate decisions on accounts to be worked to maximize reimbursement

 

qualifications:

Desired Skills

  • Understanding of the A/R process
  • Ability to verify insurance
  • Capable of meeting daily deadlines with little supervision.
  • Computer proficient (able to maneuver between multiple windows, and multi-task)
  • Analytical skills (able to identify trends)
  • Experience with review and appeal of coding based denials: non-covered, bundling, duplicates

Desired Experience:

  • 3-5 years related work experience (physician billing, collections, claims)
  • Knowledge of duplicate, no authorization and coding denials preferred

 

skills: Other

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

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