Medical Claims Processor

Job Description:The Medical Claims Biller is responsible for monitoring insurance carrier adjudication of TeamVision medical claims for one or more doctor practices. Utilize a practice EHR system and clearing house to review and submit claims to multiple medical insurance carriers Review open/unpaid claim balances and take required action.MAJOR DUTIES & RESPONSIBILITIESReview medical claims and transmit to the insurance carrier using the practice electronic health records (EHR) system and clearing house.Monitor rejected claim reports and adjust claims for resubmission to the insurance carrier.Download insurance carrier explanation of payments (EOPs) to post claim payments and denials in the EHR system.Determine if denied claims can be corrected and re-submitted to the carrier.Review aging reports to research open balances and resubmit within insurance carrier filing limits.Utilize insurance carrier websites and contact carriers as needed to investigate denials and claim status.Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system.Initiate overpayment refunds to patients and repayments to insurance carriers when required.Serve as the point of contact for the practice regarding all vision and medical claims.Support the corporate manager in maximizing claim collection rate.BASIC QUALIFICATIONSHigh school diploma3+ years of related work experienceExperience with medical billing and codingAbility to prioritize handling of issuesOrganization skills and ability to multitaskEffective communication skills (verbal, written, listening, presentation)PREFERRED QUALIFICATIONSExperience working in multiple doctor practicesExperience working with multiple insurance carriers and an understanding of their claim requirementsProven ability to identify issues and solve problems