Highlights
Utilize a practice EHR system and clearing house to review and submit claims to multiple medical insurance carriers Review open/unpaid claim balances and take required action. Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system.
Numbers & Facts
| Location | Mason, OH |
| Industry | Other/Not Classified |
| Company Size | 100 to 499 employees |
| Year Founded | 1998 |
| Website | http://www.avaconsulting.com |
Description
GENERAL FUNCTION
The Medical Claims Biller is responsible for monitoring insurance carrier adjudication of TeamVision medical claims for one or more doctor practices. Utilize a practice EHR system and clearing house to review and submit claims to multiple medical insurance carriers Review open/unpaid claim balances and take required action.
MAJOR DUTIES & RESPONSIBILITIES
BASIC QUALIFICATIONS
PREFERRED QUALIFICATIONS
The Medical Claims Biller is responsible for monitoring insurance carrier adjudication of TeamVision medical claims for one or more doctor practices. Utilize a practice EHR system and clearing house to review and submit claims to multiple medical insurance carriers Review open/unpaid claim balances and take required action.
MAJOR DUTIES & RESPONSIBILITIES
- Review medical claims and transmit to the insurance carrier using the practice electronic health records (EHR) system and clearing house.
- Monitor rejected claim reports and adjust claims for resubmission to the insurance carrier.
- Download insurance carrier explanation of payments (EOPs) to post claim payments and denials in the EHR system.
- Determine if denied claims can be corrected and re-submitted to the carrier.
- Review aging reports to research open balances and resubmit within insurance carrier filing limits.
- Utilize insurance carrier websites and contact carriers as needed to investigate denials and claim status.
- Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system.
- Initiate overpayment refunds to patients and repayments to insurance carriers when required.
- Serve as the point of contact for the practice regarding all vision and medical claims.
- Support the corporate manager in maximizing claim collection rate.
BASIC QUALIFICATIONS
- High school diploma
- 3+ years of related work experience
- Experience with medical billing and coding
- Ability to prioritize handling of issues
- Organization skills and ability to multitask
- Effective communication skills (verbal, written, listening, presentation)
PREFERRED QUALIFICATIONS
- Experience working in multiple doctor practices
- Experience working with multiple insurance carriers and an understanding of their claim requirements
- Proven ability to identify issues and solve problems
About Company
AVA Consulting provides the Best Talent to our clients. Our differentiators include: Strong Management team: helping to improve efficiencies. Deep Expertise: truly professional in their approach/delivery. Proven Track Record: worked with organizations of all sizes. Superior Execution: effective processes and well-trained staff. Long term Fulfilling Partnerships: is what we strive for Programs that fit your needs: with a total flexible approach.