Medical Claims Biller

Company: ChiroTouch
Location: Duluth
Posted on: June 23, 2022

Job Description:

The Medical Claims Biller manages timeliness and accuracy of scheduled EDI/Paper claim submissions for multiple billing company clients as well as clearinghouse rejections and report reconciliation process against billing software.

Responsibilities

* Ensure all EDI/Paper claims are reviewed for accuracy prior to payor submission
* Audit and reconcile EDI claims batches to ensure payor acceptance and balancing
* Process all EDI claim rejections and resubmissions in a timely manner
* Ensure software reports regarding unbilled claims are worked as scheduled and issues resolved
* Work effectively with clients/staff to resolve any payor edits, rejections and/or errors that effect timely claims submissions
* Report claim related issues to clients and/or staff for corrections
* Retain fax transmittal acceptance reports for all paper claims submitted via fax
* Ensure proper handling of timely filing submissions for paper claims
* Review paper claims submissions to ensure accuracy prior to mailing
* Ensure medical record attachments are signed prior to submission
* Provide billing reconciliation reports to team lead/department manager
* Demonstrate high level of professional integrity when communicating with payors, clients and other staff
* Consistently meet/exceed insurance billing benchmarks
* Provide swift escalation to clients and/or management that have negative implications related to claims submissions
* Comply with HIPAA guidelines regarding PHI
* Communicate department backlogs and develops action plans accordingly

Qualifications

* Minimum of 2 years billing experience with EDI/Paper Claim Submissions
* Minimum of 2 years working with Clearinghouse claims processing and rejection/corrections
* Comprehensive understanding of claims requirements by payor
* Thorough knowledge of commercial, government, workman's compensation and Auto payor claim process
* Exceptional understanding and adherence with payor specific billing guidelines
* Exceptional organizational skills
* Ability to multi-task and deal with high volume claims processing
* Good typing skills and experienced with office productivity tools such as MS Word, Excel, and Outlook
* Prior knowledge of Chiropractic Billing and Chiropractic Software is a definite plus

Keywords: ChiroTouch, Roswell , Medical Claims Biller, Healthcare , Duluth, Georgia