- Ensure all claims are submitted with the objective of achieving zero errors.
- Verify completeness and accuracy of all claims prior to submission.
- Accurately post all insurance payments by line item
- Timely follow up on insurance claim denials, exceptions, or exclusions
- Read and interpret insurance explanation of benefits
- Follow up on aging patient accounts and answer patient questions by phone and face-to-face.
- Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days.
- Make necessary arrangements for medical records requests, completion of additional information requests, etc. as requested by insurance companies.
- Respond to inquiries from insurance companies, patients, and providers.
- Work from the documentation in the medical record, assign appropriate modifiers, units, and time per payor requirements.
- Create claims once the above information has been determined and submission of claim within our Electronic Medical Record (EMR) system.
- Review insurance eligibility of patients prior to processing claims.
- Assist in obtaining prior authorizations for services.
- Regularly meet with Billing Manager to discuss and resolve reimbursement issues or billing obstacles.
- Regularly attend staff meetings and continuing educational sessions as requested.
- Perform other/additional duties as assigned by Supervisory or Management team.
- Computer experience is essential, including, but not limited to: practice management software, MS Office applications, Athena experience a plus
- Experience in CPT and ICD-10 coding; familiarity with medical terminology
- Excellent customer service skills and attention to detail
- Strong written and verbal communication skills
- Ability to manage relationships with various Insurance payers
- Experience in filing claims appeals with insurance companies to ensure maximum entitled reimbursement
- Responsible use of confidential information
- Perform to company standards of compliance with policies and procedures
- Ability to multi-task and work courteously and respectfully with fellow employees, clients, and patients
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Medical Billing Generalist - Boulder, United States - BoulderCentre for Orthopedics and Spine
Description
Job TypeFull-time
Description
Job Overview: The Billing Generalist is responsible for processing all billing, accounts payable, and accounts receivable. They are required to submit all clinic visits to insurance companies within 5 business days of receipt. Additionally, they must consistently follow up on unpaid claims using aging reports and file appeals when necessary to maximize reimbursement. Secondary duties include, but are not limited to, posting procedures and processing insurance/patient payments.
Department: Administrative
Reports to: Billing Manager
Schedule/Type: FT - onsite/hourly
Wage: $20-$29/hr
Bonus Eligibility: No
Requirements
Essential Duties:
Experience: Minimum of two (2) years medical billing experience in medical practice
Performance Requirements
Employee HDHP Plan
Basic Life/AD&D -Guardian
16 days of PTO per year
7-7.5 paid holidays per year
EAP
401(k) Safe Harbor Contribution
Benefit Options Requiring Employee Contributions:
• Medical
• HSA and FSA
• Dental
• Vision
• Short-Term Disability
• Voluntary Life and AD&D
• Flex Spending Accounts
• General Purpose Healthcare FSA
• Optional Protection Benefits (Accident, Hospital Indemnity, Cancer Care and Critical Illness Insurance)
• 401K
AAP/EEO Statement: Boulder Centre for Orthopedics is proud to be an Equal Opportunity employer. We are committed to providing equal employment opportunities to all qualified individuals without regard to race, color, religion, sex, national origin, disability, or protected veteran status. Our hiring decisions are based solely on qualifications, merit, and business needs. We encourage diverse candidates to apply and welcome the opportunity to build a talented and inclusive workforce.
Application Closing Date: May 1st, 2024
Salary Description
$20-$29/hr