Medical Claims Coordinator/Processor

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.

Specific Skills Needed:
Medical Billing, cash application and collection (collection is not calling demanding payment; it's researching why a claim didn't get paid and taking steps necessary to correct the info)
Years of Experience: 5 years

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