Works daily electronic billing file and submits insurance claims to third party payers.

Reviews, evaluates, and forwards manual patient account statements to payers that do not accept electronic claims or that require special handling such as client billing.

Documents billing activity on the patient account; ensures compliance with all applicable billing regulations and reports any suspected compliance issues to department leaders.

Reviews claims for accuracy and coordinates with ancillary departments as needed to provide information for audits/and or record reviews.

Based on electronic payers’ error reports, makes appropriate corrections to optimize the electronic claims submission process.

Pursues prompt follow-up efforts on aged accounts, which may involve helping to formulate written appeals.

Monitors claim rejections for trends and issues; reports these findings to supervisor or director.

Practices excellent customer service skills by answering patient and third party questions and/or addressing billing concerns in a timely and professional manner.

Assists in reviewing and/or resolving credit balances.

Participates in general or special assignments and attends required training.

Required Skills

Minimum Education: Must be a high school graduate or equivalent.

Required Experience

Minimum Work Experience: Medical office experience preferred. Strong computer skills (MS Word and Excel). Ability to maintain accuracy while working on multiple tasks in a fast-paced environment under low to moderate supervision. Good verbal and written communication skills, including professional telephone etiquette. Ability to ensure confidentiality of sensitive information and maintain HIPAA compliance. Dependable in both production and attendance. Good organization and time management skills.

Minimum Education: Must be a high school graduate or equivalent.