Medical Biller Job in South Burlington 05403, Vermont US

Our client, a growing medical practice in the Burlington area, is currently seeking an experienced Medical Biller. This is a direct hire opportunity to join an outstanding team of medical professionals!

 

This position will be temp to hire or a direct hire.

 

Hours: 7:30-4:30 M-F

 

Compensation: $16-$18/hour along with a generous benefits package upon permanent hire.

 

Summary of Duties:

 

Telephone Coverage

Answer all calls from patients regarding the following:

·        Status of insurance claims, questions regarding participation with insurance companies,   estimates of charges for future visits, explanations about their account statements involving charges and payments, provision of statements for year end.

 

Front Desk Support

·        Assist front desk staff and front desk supervisor by checking    patients in/out, opening     and processing mail.

·        Answer questions for front office staff including all aspects of patient accounts, insurance database entry requirements, participation, covered expenses, etc.

·        Speak to patients who are in the office for appointments or walk-in as needed about any account balances or claims questions.

·        Collect coinsurance and deductible payment from patients at check out by estimating patient out of pocket expenses using website and past service date information. Enter charges for private payments services for patients at check-out process.

 

Receivables

·        Accurately enter payments from insurers and patient statement remittances to patient accounts.

·        Create separate deposit slips for patient private payments and insurance company checks. Post the deposits to general ledger and post payments to patients’ accounts accordingly.

·        Print out day-sheet and balance receipts to confirm data entered equals total amounts of receipts.

·        Photocopies of explanations of benefits are made for any claims processed in error, including duplicate payments, unpaid lines of service, or inappropriate recoupments. These are then followed up with the insurance companies to have reprocessed or a letter of appeal is drafted and sent with chart documentation.

·        Maintain file for all explanations of benefits from insurance companies for all patient service dates payments and adjustments.

 

      Aged Claims

·        On a regular basis generate reports and follow up unpaid claims.

·        Check insurance company websites or call insurance companies to inquire about status of unpaid claims.  Prioritize by claim submission time requirements, amount of claims and age of claims.  If any submittal information is erroneous or insufficient, then obtain correct information from patient charts or insurance company to resend claim or have reviewed.   If necessary transfer balances to patient responsibility when there is no response from insurance company or when insurer has paid the patient directly.

·        Update system database for referring providers, including new providers, address changes, telephone and fax numbers, and provider identification numbers.  Also maintain database for insurance company addresses, phone numbers and clearing house payor numbers.

·        Document in patient system account all efforts and action taken on claims in process including communication with the insurance company or patient.

 

Charge Entry

·        Review for accuracy the keyed information in the fields required for correct claim submittal:  insurance company, patient ID numbers, referring provider info, patient flags, etc.

·        If information to send claim is missing, erroneous or insufficient, obtain needed information from patient chart, insurance companies, front desk staff, providers, referring or primary physician’s office, insurance company websites, or telephone patient.

·        Enter diagnoses and procedure codes and batch claims electronically or on paper with documents as needed. 

·        File all fee tickets including those that need to be held temporarily until pathology report findings are received.

 

Claims Submission

·        On a daily basis, using current software, create a file for claims to be sent electronically to claims clearing house process secondary paper claims to insurers.

·        Research and collect the information needed to correct erroneous data on locally rejected claims.

·        Review payor response reports from clearing house for claims rejected at the clearing house or payor level.  Research to correct fields and rebatch claims.

·        Create and send appeals to insurers as needed and maintain file for copies of documents.

 

Requirements:

 

Qualified candidates are encouraged to submit a cover letter resume in confidence to Natalie Duval at nduval@westaff.com .

 

No phone calls. No relocation package is offered.

 

While Westaff appreciates all resume submittals only candidates selected for an interview will be contacted during our search.