- Career Level Entry Level
- Experience 5 Years
- Education Certificate
Primary Position Duties
- Process physician charges for office, hospital and nursing home services.
- Process electronic and manual payments and adjustments from insurance companies and patients.
- Prepare and submit clean claims to various insurance companies either electronically or on paper.
- Review account status, making recommendations to the practice for collection turnover or account adjustment.
- Evaluate patient’s financial status and establish payment plans.
- Answer billing inquiries from patients, practice staff, and insurance companies.
- Identify and resolve patient billing issues.
- Maintain strict confidentiality in accordance with HIPAA guidelines and regulations.
- From five to ten years’ of progressively responsible experience with medical billing and coding, ERA and manual payment posting, claim review and RCM policies and procedures.
- Working knowledge of Medicare, Medicaid and Workers’ Compensation Part B claim processing and payment posting.
- Ability to establish and maintain accurate and complete records concerning billing activity.
- Strong understanding of and experience with HCPCS and ICD systems.
- Excellent interpersonal skills to work with others to influence and gain cooperation.
- Ability to work independently, with little direction required.
- Ability to recognize, evaluate, and solve problems.
- Strong verbal and written communication skills.
- Extensive knowledge of the claims development process, as well as third party insurance program requirements.
- Ability to handle a variety of tasks with speed, attention to detail, and accuracy.
- Computer literate, experience with basic software packages, specifically Word, mail merge, and Excel.
- Data entry capability (50 wpm).
- Experience using AdvancedMD billing software a plus but not a requirement.
- High school diploma or GED. Some college coursework, coding coursework/certification is preferred.
These positions are in Medsphere’s Mayfield Heights (Cleveland), OH, and Chesterfield (St Louis), MO, office locations.