Under routine supervision, prepares and submits insurance claims; reviews and adjusts accounts to ensure accurate and thorough billing of claims; monitors and ensures timely payment of bills.
Determines billable claims; corrects and submits insurance claims. Completes insurance data for patient claims; processes, researches and corrects accounts; verifies diagnosis and authorization codes; identifies liability and guarantors; reviews and adjusts account balances; interprets Explanation of Benefits (EOBs); analyzes billing components.
Posts payments and adjustments in billing databases; prepares batches for posting. Verifies all identified insurance carriers for eligibility; confirms carrier policy.
Reviews claims before submission to insurance carrier; assesses adjudicated claims.
Creates, organizes, corrects, updates and maintains accounts on data spreadsheets using medical billing software.
Ensures correct and prompt claims payments through confirmation from providers. Tracks and monitors claim processing; resolves outstanding claims.
Assists with training and quality verification of lower level billing specialists.
Provides assistance to patients, carriers, and other concerned parties. Assists in distributing workload among coworkers; provides assistance to coworkers; monitors and reviews coworkers'' progress; assists in training of new employees.
Knowledge of medical billing and accounting procedures and applications.
Knowledge of claims review, analysis and quality assurance.
Knowledge of commercial insurance and government reimbursement programs.
Knowledge of basic medical terminology and clinic processes.
Knowledge of reception, typing, computer operations, and filing.
Skill in operating a personal computer using a variety of software including medical billing applications.
Skill in tracking and accomplishing multiple tasks and assignments.
Skill in establishing and maintaining cooperative working relationships with other employees.
Skill in conducting successful telephone consultations and operating a multi-line office phone system.
An Associate's Degree in business, finance or related discipline. Progressively responsible related work experience may be substituted on a year-for-year basis for college education.
Non-supervisory - Three (3) years of experience working in a medical office performing medical billing processes. An equivalent combination of relevant education and/or training may be substituted for experience.
The following demands are representative of those that must be met by an employee to successfully perform the essential functions of this job. This position requires the ability to sit for long periods of time. ANMC is not a latex free environment. Therefore, some latex exposure can be expected.