Be an advocate for our Members by completing monitoring and resolving claim denials and/or low insurance payments.
Work the aging accounts and collect pending receivable payments from insurance companies.
Prioritize and effectively communicate.
Work with the team to achieve and maintain key AR benchmarks.
Meet Productivity Goals.
Regularly review accounts and prepare information for the collection agency, correcting and resubmitting claims to third-party payers when necessary.
Check each insurance payment for accuracy, including contract-discount compliance.
Review patient bills for accuracy and obtain missing information before identifying and billing secondary and tertiary insurances.
Call insurance companies to settle payment discrepancies or investigate unpaid claims within the standard billing cycle timeframe.
Research and resolve accounts.
Provide additional education back to team members on Member specifics or payer guidelines.
Adhere to all HIPAA guidelines and regulations keeping all of the data in our system safe and secure.
Reliable and punctual in reporting for work and taking designated breaks.
Abilities and Knowledge
Making decisions, problem solving, and a knack for finding solutions are key in this role.
Ability to resolve payment issues and effectively follow up with insurance companies.
Knowledge of insurance guidelines, especially those associated with Medicare and Medicaid as well as ICD-10 and CPT codes.
Maintain focus with interruptions
Critical and analytical thinking skills to help resolve billing issues and collect payments.
Top-notch memory and confidentiality in all situations.
Be passionate about quality customer service.
Be able to perform in all forms of communication (i.e., phone and email). You ll be interacting with insurance companies and patients regarding accounts, past due balances, unpaid claims, and other billing-related items. Strong communication skills are a must.
Be fluent in billing language and comfortable with AR software.
Meet weekly metrics by working the required number of accounts per day, which includes working denials, sending appeals, communication with our members and patients.
Education and Experience
Required:
Two years of experience in full-cycle medical billing or schooling
Three years of customer service experience
Healthcare compliance and terminology knowledge
Preferred:
Experience in physical therapy billing a plus but not required. Other areas of billing, such as orthopedics, chiropractic, or any specialty medicine.
