Medical Billing Technician (re-ad 24-00144)
Associate’s degree in accounting, business administration or a related field; two years of experience in processing electronic medical claims, preferably Behavioral Health and specifically related to billing for Intellectual Disabilities/Developmental Disabilities services; or an equivalent combination of training and experience. Familiarity with medical billing codes, Medicaid, Medicare, and commercial insurance carriers. Strong working knowledge of Microsoft Office, including Word, Excel, and Outlook. Strong attention to detail and the ability to work in a fast-paced, team-oriented environment with a focus on communication required. Pre-employment drug testing, FBI criminal background check, and education/degree verification required.
• Work aged receivables utilizing A/R reports or as assigned by Leadership.
• Generate, review and submit electronic claims for various insurance carriers using EHR (Profiler software).
• Review and assess adjudicated claims for timely and proper payment of outstanding balances.
• Research, correct, and resubmit or reprocess unpaid claims as necessary.
• Review zero payments, including denials, correspondence, etc.
• Research account balances for accuracy.
• Review and interpret Explanation of Benefits (EOB) for denials and underpayment of codes.
• Research and resolve denials and underpayments with insurance carriers.
• Verify insurance eligibility and confirm carrier’s policy for referral and authorization requirements, as needed for claim adjudication.
• Submit appeals and claim reconsideration requests in a timely manner.
• Meet productivity goals/benchmarks as set and communicated by A/R leadership.
• Serve as primary customer service representative for payer and consumer inquiries/calls.
• Work collaboratively with other A/R Billing staff, healthcare providers, insurance representatives and consumers as needed.
• Post claims payments; perform other work as required.
An Equal Opportunity Employer Committed to Hiring a Diverse and Bilingual Workforce
40 hours/week; Monday – Friday; 8:30 a.m. – 5:00 p.m.