Business Office/Medical Billing - Over the Mountain Peds
Birmingham-AL-35201-United States
Job Summary
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Responsible for accurate and timely data entry of all practice charges and balancing of controls; data entry on all miscellaneous insurance payments, communication with insurance companies/patients and the timely follow-up of all outstanding claims with third-party payers.
Responsibilities
Update/verify demographics, responsible party designation; verify insurance eligibility and benefits coverage from all applicable insurance sources.
Obtain pre-authorization/pre-certification as required.
Contact or review insurance systems to determine claim status; balance due on previously billed accounts. Resolve problems by phone, payor’s website or written correspondence, including coordination of benefits payable from primary/secondary payor. Draft appeals regarding claim denials, or improper payments and requests rebilling of accounts as needed.
Obtains applicable insurance print-outs to determine eligibility level for existing insurance coverage.
Updates patient accounts with appropriate insurance codes.
Determines self-pay patient eligibility for alternative insurance/benefits e.g. Medicaid, VFC, Tots & Teens
Establishes payment agreements with patients, where applicable, for bill payment and conducts follow-up/tracking of previous payment arrangement; Refers patients to collection agency if previously established payment agreements are defaulted.
Responds to billing related inquire from patients.
Accepts co-payments and make daily bank deposits
Completes billing forms according to payor’s requirements. Create and submit claims and appeals within established time constraints either electronically or manually. Reviews billing reports (EOB/ERA) to ensure proper receipt of all claims, and documents records accordingly.
Tracks and reconciles charges or payments received using automated files, manual charge records.
Reviews, credits or modifies charges as needed.
Other responsibilities as assigned
Education
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High school diploma or equivalent required
Experience
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Three year's experience in healthcare billing/insurance work, with emphasis on financial or insurance-related work.
Licensures, Certifications, and/or Registries 
PI273336777
