Top national managed care organization looking for a Medical Billing Specialist to work in Warwick RI! Great opportunity, please contact us today! Temp to Perm opportinuty All applicants must be fully Vaccinated for Covid-19 Working in support of clinical care teams, the Medical Biller will perform tasks and functions associated with all aspects of medical billing. The Medical Biller will follow the established job performance standards for the position and will have a fundamental knowledge of hospital and physician billing procedures. Duties & Responsibilities: Daily operations to ensure appropriate billing: Has a general knowledge of third party insurance and an extensive knowledge of the insurance carrier assigned to include but not limited to the following: timely filing limits, coordination of benefits, deductibles, PCP, HMO, PPO(Federal and State insurance), capitation, referrals, specialty services, in network co-pays, out of network co-pays, authorizations, dual coverage, referrals and consent forms, coverage dates, covered services, non-covered services, coverage limitations and maximums.Has working knowledge of 837 billing and 835 payer process Each Medical Biller will be responsible to keep up with changes of their assigned carrier and relay this information to the Billing Manager.Explanation of Benefits (EOB): General knowledge of EOB's for all third party carriers.Extensive knowledge of EOB for insurance assigned. Responsible to know when and where to transfer charges, write off charges, resubmit charges, and what codes to use to do each function.Process all payments on EOB.Payment Processing: Responsible to process all payments to the correct transaction and insurance.Apply payments and contractual write off to each individual transaction in amounts paid. Remove payments that insurers have recouped and adjust or resubmit the charge as appropriate. Payments for the month are to be applied by the end of month closing.Collection processes: Work denied claims on EOB's and outstanding claims identified on in house reports. Responsible to research claims by obtaining the appropriate information (i.e. request progress note, obtain claim form. ) and resubmit appropriately. Send the appropriate back up that is needed to recoup charges. Keep current with all of collection policies and procedures. Must meet job performance standards.Secondary Claims: Will have the knowledge to bill for coordination of benefits to secondary carriers, process and prepare the claims and the necessary documents required for reimbursement.Write offs: Responsible to understand the write off policies, processes and codes to allow for the effective management of uncollectible accounts. Prepare the Write-off Approval Form for approval by the Billing Manager.Reporting: End of day (EOD) Reporting: Will balance all work at the end of the day in accordance with established policies and procedure. End of Month (EOM) Reporting: EOM reports are prepared at the end of the month immediately after the month closing. Third party and self pay cash reports will detail unapplied revenue. Inpatient, surgery, and pregnancy reports will detail the unposted charges.General reporting: Will prepare information and reports as requested by the Billing Manager.Will assist with the development, processing and evaluation of other internal reports. Update accounts: Will update patient accounts including but not limited to the following: demographics information, sliding fee scale rating, insurance coverage and changes, etc. Process refunds, discounts, adjust/remove charges and payments as appropriate. Eligibility: Eligibility will be performed on patients via phone, internet web sites, and other reports. The MBS will update patient account with the most current information regarding coverage, eligibility date, PCPs, covered service and obtain mailing address for claims, and any other pertinent information needed to bill the services.Patient Statements: Prepare, review, research and submit on a schedule established by the Billing Manager.Third Party Correspondences: Each MB is responsible to correspond with their assigned insurance carrier both verbally and in writing. Relay any changes to the Billing Manager. Relay repeated problems to the Manager. Work with the insurance carrier to resolve claims issues.Patient Correspondences: The MB will correspond with patients to obtain updated information as needed. Communication may be either written or verbal. Once the information is obtained, the MB will update the computerized billing system.Customer services: The MB will provide support to other staff and patients who have questions concerning billing and reimbursement. The MB must conduct themselves professionally and demonstrate sensitivity to language and cultural differences.Maintain confidentiality at all levels of interaction: Responsible to know HIPPA guidelines and utilize them in every aspect of the job. Maintain confidentiality as outlined in the policies.. Qualifications: Ability to gain proficiency in Practice Management software.Access to reliable transportationWorking knowledge and prior experience with medical terminology required.Working knowledge of automated billing systems.Good verbal and written communication skills; ability to read/write/speak English required.Knowledge of HIPPA regulations.Ability to communicate with people of various diverse backgrounds in a sensitive and compassionate way. Education/Experience: Two to three years experience as Medical Biller, Third Party Biller, or equivalent experience in a health care setting required Post High School completion of a medial billing certification program or equivalent required 13 week contract to start with Perm potential Schedule 9-5 M-FEqual Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status. For certain assignments, Covid-19 vaccination and/or testing may be required by Randstad's client or applicable federal mandate, subject to approved medical or religious accommodations. Carefully review the job posting for details on vaccine/testing requirements or ask your Randstad representative for more information.