Medical Claims Processor

I3 INFOTEK INC; Cincinnati (OH); On-site; USD 40,000 - 65,000; Full time

Job summary

I3 INFOTEK INC in Cincinnati, OH seeks a Medical Claims Biller to monitor insurance adjudication for multiple practices. You will use an EHR system and a clearing house to review and submit claims to various carriers.

The role requires 3+ years of medical billing experience, knowledge of claim requirements, and the ability to prioritize tasks, handle multiple accounts, and work with carrier portals to research denials and postings.

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.

Responsibilities

• Review medical claims and transmit to the insurance carrier using the practice 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.

Skills

Medical billing

Claims processing

Prioritization

Multitasking

Organization

EHR systems

Clearinghouse

Carrier portals

Education

High school diploma

Tools

EHR system

Clearinghouse

Carrier portals

Job description

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

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