Medical Biller

About the Role

Atlanta Hand Specialist is inviting applications for the position of Medical Biller. The professional in this role will be tasked with ensuring the timely and accurate submission of medical claims—both technical and professional—to insurance providers. This role may be based in various healthcare settings such as physician offices, hospitals, or nursing homes.

Key Responsibilities

• Secure referrals and necessary pre-authorizations for medical procedures.
• Verify patient eligibility and benefits coverage.
• Audit patient bills to ensure accuracy and completeness; obtain missing information when required.
• Process claims through billing software, handling both electronic and paper submissions.
• Maintain knowledge of insurance procedures, including HMO, PPO, Medicare, and Medicaid guidelines.
• Follow up diligently on unpaid claims within the standard billing timeframe.
• Validate insurance payments to ensure they comply with contract discount agreements.
• Contact insurance providers to resolve any discrepancies in payment.
• Identify and bill ancillary insurances such as secondary and tertiary coverage.
• Regularly review all accounts to monitor insurance and patient follow-up needs.
• Conduct research and file appeals for denied insurance claims.
• Respond to inquiries from patients and insurance companies regarding assigned accounts.
• Arrange patient payment plans and manage collection accounts.
• Update billing software for any changes in rates.
• Maintain cash spreadsheets and generate collection reports.

Required Qualifications and Experience

• Minimum educational qualification: High School diploma or equivalent.
• Preferred background includes an Associate degree in Business Administration, Accounting, or Healthcare Administration.
• Experience ranging from one to three years in a medical office environment.

Skills and Abilities

• Familiarity with HMO, PPO, Medicare, Medicaid, and other payer systems and their requirements.
• Competent in using billing software, computer systems, and 10-key calculators.
• Strong communication skills for resolving issues with insurance payers via phone.
• Excellent customer service aptitude when dealing with patients and their families from diverse backgrounds.
• Capability to operate effectively in a team setting.
• Analytical problem-solving skills to investigate and resolve discrepancies, denials, appeals, and collections.
• Knowledge of accounting and bookkeeping principles relevant to billing.
• Understanding of relevant medical terminology used in claims processing.