The Billing Collections Rep is responsible for resolving unpaid insurance accounts, by contacting insurance companies through various means to solicit payment for applicable patient encounters.
Responsibilities: 1.Develops positive relationships with payer representatives in order to collect accounts timely.
2.Investigates pended claims to determine why claims were pended and resolve reasons for the pended scenario.
3.Identifies and resolves trends with pended claims, which includes appeals for untimely claim submission and resolving provider credentialing issues.
4.Accurately posts resolutions to accounts including updating and billing insurance and correct and repost.
5.Establishes and maintains provider manuals for assigned insurance carriers and subsequent plans.
6.Monitors physician???s enrollment to not exceed timely filing requirements.
7.Other duties as required.
Other information: Technical Expertise 1.Experience in processing and billing physician claims is required.
2.Experience in the technical aspects of billing and collections required. This includes CPT and ICD coding knowledge, understanding pay3r remittance coding/process and outcomes analysis/reporting.
3.Experience working with applicable management team members and clinic staff required.
4.Proficiency is the management of CMS formatted claims required.
5.Proficiency in MS Office [Outlook, Excel, Word]. Epic experience is preferred.
Education and Experience 1.Education: High school diploma or equivalent is required. Bachelor???s Degree is preferred.
2.Certification: Medical Billing Certificate is preferred.
3.Years of relevant experience: 1 to 2 years required. 5 years relevant experience preferred.