Job Description
Summary/Objective
Responsible for accurately processing patient billing, managing insurance claims, and ensuring timely reimbursement. Duties include reviewing medical records, coding procedures, and collaborating with healthcare providers and insurance companies to resolve discrepancies. Strong attention to detail, knowledge of medical terminology, and proficiency in billing software are essential for success in this role.
Essential Functions
- Verifies insurance benefits and confirm patient eligibility
- Obtains prior authorization for services as required
- Reviews clinician entered charges entered for accuracy before generating claims
- Prepares and submits claim files
- Posts insurance and clients payments accurately and in a timely manner
- Analyze and address ERA/EOB denials by taking appropriate corrective action
- Manage accounts receivable and actively pursue outstanding balances
- Oversee client collections to ensure timely payment
- Handle insurance appeals for denied or underpaid claims
- Stay informed and compliant with payor reimbursement policies, procedures, and guidelines
- Monitor and apply contracted fee schedules to ensure accurate expected payment
- Foster positive communication and relationships with patients, clinicians, physicians, third-party payors, and other Boundless staff)to ensure exceptional customer service
- Adheres to company policies and procedures in addition to regulations, laws and other requirements from applicable governing bodies, certification, licensure and/or accreditation entities, etc.
- INCLUDE STATEMENT ABOUT WORKSPACES OR ENVIRONMENTS THAT THIS POSITION WILL TYPICALLY WORK
Other Responsibilities
- Other duties as assigned.
Supervisory Duties
This position has no supervisory responsibilities.
Education, Skills, Experience and Requirements
- High school diploma required; college coursework a plus.
- Preferred 1-3 years’ experience in medical billing and collections, as well as insurance verification.
- Proficient in Microsoft 365
- Medical Coding Certification (Preferred)
- Driver’s license and insurable driving record, if applicable.
Competencies and Attributes
Oral and written communication
Professionalism
Organizational skills
Ability to stay focused
Ability to prioritize multiple tasks
Computer skills
Professional phone etiquette
Physical Demands/% of time
Lifting and carrying up to 20lbs <25%
Standing and/or walking <25%
Near visual acuity >75%
Use of electronics (i.e. computer, tablet) >75%
Manual dexterity >75%
Use of office equipment (i.e. copier/scanner) >75%
Sitting >75%
Verbal communication >75%
Work Hours: Typically Monday through Friday from 8 am to 4:30 pm
Travel Requirements: Minimul travel is primarily local during the business day
...Overview Ansible Government Solutions, LLC (Ansible) is currently seeking a Vascular Surgeon to support operations at the Oklahoma City VA Medical Center located at 921 NE 13th St., Oklahoma City, OK 73104. Full-time and Locum Tenens positions with generous compensation...
Johnson Controls is seeking a highly strategic and dynamic Global Customer Operations Director to join our Data Center Solutions team within the Information Technology sector. This role is pivotal in driving operational excellence and enhancing customer satisfaction across...
I am looking for someone to keep the house tidy and help my 9 year old with his Spanish.
...Job Description Caregiver/Home Health Aide (HHA) As members of the interdisciplinary team who provide hands-on personal care, report changes in the clients condition, perform simple procedures as an extension of therapy or nursing services, and provide incidental...
...Licensed Esthetician Join Our New Team at Hand & Stone Massage and Facial Spa! Location: 1646 Highway 160 W, Suite 103, Fort Mill, SC 29708 Employment Type: Full-Time/Part-Time Compensation: Competitive Base Pay + Commissions + Tips About Us: At Hand...