Medical Billing Office seeking Full-Time Medical Biller (experienced or entry-level) with a minimum of 2 years office experience.
Manage facility, provider and member inquiries, appeals and balance billing including correspondence.
Keep clients informed of all disputes and status providing reporting as necessary.
Keep appropriate individuals informed of critical matters that may impact client retention/revenue.
Review and prioritize claims based on processing criteria, timelines, interdepartmental demands, member benefits, regulatory criteria, etc.
Evaluate and research claims depending on the medical plan design and how best to interact with clients, facilities, providers and members.
Manage a daily running inventory of claims.
Contact facilities and providers to discuss charge adjustments and rationale while obtaining signed agreements for reimbursement or adjustments when needed.
Handle member inquires in accordance to their medical plan.
Working hours: 8:00 AM - 5:00 PM
Ability to develop/maintain long-term working relationships with providers.
Should possess a moderate to high level of claim editing, coding, RVU and CMS-based pricing knowledge with an emphasis in researching solutions for the above items as needed.
Minimum of three years experience in a medical healthcare claims role dealing with facilities, providers and members is required.
Background in healthcare claims management environment including provider negotiation, hospital billing, claims adjudication and administration or the ability to interpret benefit plans.
One to two year(s) minimum insurance company/TPA.hospital experiences, with emphasis in claims, fee schedules, contracting, negotiating, andor external vendor relationship management preferred.
To be considered please email your resume to email@example.com or call us at 949-727-3205
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