Medical Billing Specialist

The medical biller is responsible for the timely submission of professional medical claims to insurance companies and auto companies.

• Obtaining referrals and pre-authorizations as required for procedures (auto and medical insurance)
• Checking eligibility and benefits verification for treatments, hospitalizations, and procedures (auto and medical insurance).
• Reviewing patient bills for accuracy and completeness, and obtaining any missing information.
• Posting
• Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing (CMS 1500)
• Following up on unpaid claims within standard billing cycle timeframe.
• Rejections (Front end and back end)
• Checking each insurance payment for accuracy and compliance with contract discount.

• Calling insurance companies regarding any discrepancy in payments if necessary
• Calling auto adjustors to verify auto claim and payment status
• Identifying and billing secondary or tertiary insurances.
• Reviewing accounts for insurance of patient follow-up.
• Researching and appealing denied claims.
• Answering all patient or insurance telephone inquiries pertaining to assigned accounts.
• Setting up patient payment plans and work collection accounts.
• Updating billing software with rate changes.
• Updating cash spreadsheets, and running collection reports.

Education and experience

• Associate's Degree or higher
• Knowledge of business and accounting processes usually obtained from an associate's degree, with a degree in Business Administration, Accounting, or Health Care Administration preferred.
• A minimum of one to three years of experience in a medical office setting.

Knowledge, skills and abilities

• Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, Auto, and other payer requirements and systems.
• Competent use of computer systems, software, and 10 key calculators.
• Familiarity with CPT and ICD-10 Coding.
• Effective communication abilities for phone contacts with insurance payers to resolve issues.
• Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds.
• Ability to work well in a team environment. Being able to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion.
• Problem-solving skills to research and resolve discrepancies, denials, appeals, collections.
• A calm manner and patience working with either patients or insurers during this process.
• Knowledge of accounting and bookkeeping procedures.
• Knowledge of medical terminology likely to be encountered in medical claims.
• Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
• Ability to multitask.

Days: Mon-Friday

Hours: 40

Locations: All Three Oak Park, Redford, Roseville

Rate: 25-30$/Hr Negotiable

Benefits: Upon completion of 90-day probationary period: Medical Insurance, Paid Holidays; 401k to start (no matching).

Job Type: Full-time

Pay: $25.00 - $30.00 per hour

Benefits:

• 401(k)
• Health insurance

Schedule:

• 8 hour shift
• Monday to Friday

COVID-19 considerations:
To keep our staff safe, we have gloves, face masks and barriers installed.

Application Question(s):

• What is the earliest date you can start work?

Education:

• Associate (Required)

Work Location: Multiple Locations