Senior Medical Insurance Biller - HMO & Managed Care

FlexStaff Careers; Baldwin (NY); On-site; USD 50,000 - 70,000; Full time

Job summary

A health management company is seeking a skilled Medical Insurance Biller to join their team onsite in Baldwin, NY. The ideal candidate will have extensive experience in collections, HMO, and Managed Care billing. Responsibilities include verifying patient eligibility, managing billing and collections, performing follow-up on claims, and resolving claim denials. This role offers an opportunity to contribute to a team serving rehabilitation and nursing facilities across the region.

Qualifications

• Seasoned experience in Medical Insurance billing.
• Familiarity with HMO and Managed Care billing processes.
• Ability to verify patient eligibility and benefits accurately.

Responsibilities

• Verify patient eligibility and benefits via payer portals and phone.
• Manage billing and collections to ensure timely reimbursement.
• Perform A/R follow-up on unpaid, underpaid, or denied claims.
• Contact insurance carriers to request reprocessing and claim status updates.
• Identify, analyze, and resolve claim denials; prepare and submit insurance appeals.
• Review A/R and aging reports to prioritize accounts and determine next steps.
• Read and interpret EOBs/ERAs to confirm payments, adjustments, and patient responsibility.
• Prepare and submit corrected claims and supporting documentation as needed.
• Communicate with payers throughout the claims lifecycle to drive resolution and payment.

Skills

Experience in Insurance billing

MLTC billing knowledge

Collections management

Job description

A health management company is seeking a skilled Medical Insurance Biller to join their team onsite in Baldwin, NY. The ideal candidate will have extensive experience in collections, HMO, and Managed Care billing. Responsibilities include verifying patient eligibility, managing billing and collections, performing follow-up on claims, and resolving claim denials. This role offers an opportunity to contribute to a team serving rehabilitation and nursing facilities across the region.