Principal Job Responsibilities:
- Ensures all claims are submitted with a goal of zero errors
- Verifies completeness and accuracy of all claims prior to submission
- Researches rejected and denied claims; reconciles with original claim; makes any necessary corrections; resubmits corrected claims, or submits appeals for reconsideration, as appropriate to the situation
- Makes necessary arrangements for medical records requests, completes additional information request, etc., as requested by insurance companies
- Follows up with all insurance carriers on unpaid claims until the claims are paid and have reached a zero balance
- Prepares, reviews and sends patient statements for service amounts such as co-payments, deductibles and coinsurance
- Evaluates patient’s financial status and establishes budget payment plans; processes accounts to collections for nonpayment, as required; follows up and reports status of delinquent accounts
- Communicates effectively with providers and patients regarding claims/billing questions or complaints
- Maintains goodwill with both patients and insurance companies; responds in a timely manner and ensures all issues are resolved according to established guidelines and required laws and regulations
- Regularly meet with Director to discuss and resolve reimbursement issues or billing obstacles
- Completes work with excellent attention to detail to ensure compliance with departmental/company/HIPAA standards
- Maintains strict confidentiality of information at all times
- Performs other duties as assigned
Qualifications:
- High school diploma or equivalent
- Minimum 2 years of experience in healthcare billing
- Excellent attention to detail, problem solving and critical thinking
- Must have a team player mindset with adaptability to monitor own work
- High degree of professionalism and customer service
- Excellent written and oral communication skills
- Working knowledge of Microsoft Word and Excel
Required Experience:
- Medical Billing Experience – REQUIRED: 2 years
- Microsoft Excel – REQUIRED: 2 years