• Accurately and efficiently code from progress notes and operative reports and enter them into the billing system daily.
• Send electronic claims and ensure needed authorizations and reports accompany each claim daily.
• Post payments and ensure claims are accurately paid according to the fee schedule.
• Reconcile all unpaid claims on time by correcting or obtaining any missing information and resubmitting to the insurance company.
• Work on both insurance and patient AR weekly.
• Send patient statements for all outstanding balances and make collection calls.
• Communicate consistently with the manager regarding any billing issues.
• Meet weekly with the manager and doctor to update on all billing matters, focusing on the status of each outstanding claim and AR.

Skills: Medical Coding, Claim Submission, Payment Posting, Claim Reconciliation, AR Management, Patient Collections, Issue Communication, Billing Reporting

• Data and charge entry, payment posting.
• Encounter tracking to ensure all visits are captured.
• Submit paper and electronic claims.
• Balance on a daily and monthly basis.
• Follow up on all unpaid claims or denials, as per company protocol.
• Develop and mail patient statements per company protocol.
• Refund management, per company protocol.
• Response to client concerns and patients' billing inquiries.
• Generate all month-end reports, as per company protocol.
• Routine meetings with the direct supervisor to review the status of the monthly workflow.
• Attend mandated company training programs.
• Attend bi-weekly team meetings.

Skills: Charge Entry, Payment Posting, Claim Submission, Claims Follow-Up, Patient Billing, Refund Management, Report Generation, Workflow Coordination

• Post medical charges into the medical manager software to meet daily and monthly goals.
• Coordinate with clinics to ensure all outstanding bills are collected.
• Data entry of patient demographics and input charges accordingly.
• Appropriately assign modifiers.
• Take responsibility for authorizations.
• Take charge of medical reimbursements.
• Initiate refunds for patients.
• Various billing and collections functions to ensure accurate and timely claim processing.
• Confirm patient benefits and insurance.
• Follow up on late or missed payment notices.
• Understand ICD-9, ICD-10, and CPT codes.

Skills: Charge Posting, Billing Coordination, Data Entry, Modifier Assignment, Authorization Management, Reimbursement Handling, Patient Refunds, Insurance Verification

• Take responsibility for insurance accounts receivable follow-up.
• Investigate underpaid and overpaid claims and do appeals
• Patient accounts receivable follow-up.
• Call patients for outstanding balances.
• Telephone etiquette with phone calls to/from clients, patients, and insurance companies.
• Assist with any special projects.
• Accountable for charge and data entry.

Skills: Insurance AR Follow-Up, Claims Investigation, Patient AR Management, Patient Outreach, Phone Etiquette, Project Assistance, Charge Entry, Data Entry

• Work to get accurate reimbursement on client accounts and identify and communicate denial trends to improve client performance.
• Follow up on outstanding payers’ A/R (Accounts Receivable) and resolution of denials.
• Contact insurance companies by phone, email, fax, and written correspondence to resolve issues preventing claims from being processed correctly, including verifying benefits and eligibility dates, and according to the schedule of disposition to be worked based upon filing deadlines.
• Prioritize claims on the rebill report for investigation.
• Identify denial trends.
• Follow up on outstanding medical A/R with no response from the insurance carriers.
• Handle EDI (Electronic Data Interchange) transactions, including reconciling carrier submissions, edits, and rejection reports.
• Update the client account in the system with any action taken or additional information attained when verifying benefits.
• Process and review statements.
• Adhere to all established company policies and departmental procedures.
• Remain current on Federal and State regulations and statutes that influence collections of receivables.

Skills: Reimbursement Management, AR Follow-Up, Claims Resolution, Benefit Verification, Denial Analysis, EDI Processing, Account Updating, Regulatory Compliance

• Completely encode patient demographics into the billing software.
• Validate and encode the insurance coverage of patients.
• Ensure that payments are made to the correct healthcare provider.
• Ensure accuracy of work output at all times.
• Post medical claims information as line items into the system.
• Ensure accuracy of entries related, but not limited to, CPT and ICD-10 codes.
• Monitor individual and group work output by submission of productivity reports.
• Perform quality audits of entered medical bills.
• Request and follow up on missing information on a claim.
• Keep up to date with coding rules on ICD-10 and CPT.
• Be familiar with regulations and guidelines set by Medicare, State Programs, HMO, and PPO.
• Maintain patient confidentiality.

Skills: Demographic Encoding, Insurance Verification, Payment Accuracy, Claim Posting, Coding Accuracy, Productivity Reporting, Quality Auditing, Regulatory Knowledge

• Obtain patient demographic, insurance, and medical information via computer, hardcopy, and/or phone by using several methods, including electronic medical records and hospital websites.
• Data entry of patient demographic, insurance, and medical information into the computer system for insurance claims submission and patient billing.
• Data entry of payments received from insurance companies and patients.
• Contact insurance companies to ensure that pre-certification is obtained for procedures that require authorization.
• Verify insurance eligibility.
• Follow up on patient accounts.
• Answer incoming phone calls in a timely and courteous manner, and resolve callers’ inquiries.
• Perform adjustments on accounts that require correction.
• Ensure payment of patient accounts, including light collections.

Skills: Demographic Collection, Data Entry, Payment Posting, Authorization Coordination, Eligibility Verification, Account Follow-Up, Customer Service, Account Adjustments

• Apply payments and adjustments to patient accounts.
• Follow up with insurance payers for the processing of appeals and errors.
• Interact with clinicians, managers, and clients to resolve outstanding items.
• Maintain current understanding of applicable coding guidelines, state and federal regulations, and managed care guidelines.
• Meet productivity and quality assurance benchmarks.
• Perform quality assurance on the team’s work and provide feedback to management and team members about job performance.
• Provide phone coverage.
• Receive and resolve inquiries, concerns, or complaints related to patient accounts from patients, insurance carriers, employers, etc.
• Responsible for the resolution and appropriate refunding of credit balances, denied claims, and charges on hold, including working credit balance reports.
• Review and code the patient's medical record in compliance with standard coding guidelines.
• Review explanations of benefits for correct adjudication and payment according to applicable managed care contract terms and reimbursement.
• Review unpaid claims, researching denials and/or lack of activity to ensure timely payment and maintain cash flow.

Skills: Payment Application, Claims Follow-Up, Issue Resolution, Coding Knowledge, Quality Assurance, Phone Support, Credit Balance Management, Claim Review

• Use the electronic EMR billing system appropriately to submit claims daily.
• Help with entering charges and payments.
• Accurate analysis and coding of medical encounters.
• Timely working of claim rejections.
• Timely and effective denial management.
• Continuously monitor payer rules and regulations.
• Perform posting charges.
• Perform completion of claims to payers.
• Conduct duties in a professional and timely fashion.
• Take responsibility for processing claims.
• Achieve maximum reimbursement for services provided.
• Help train other staff members on billing, coding, and payment posting.
• Help to answer phones and help customers at the front desk.

Skills: Claim Submission, Charge Entry, Encounter Coding, Rejection Resolution, Denial Management, Payer Compliance, Reimbursement Optimization, Staff Training

• Verify and ensure the accuracy, completeness, and appropriateness of diagnosis and procedure codes based on services rendered.
• Review medical record information to identify all appropriate coding.
• Review provider medical records to ensure compliance with established CMS/AMA documentation requirements for CPT and NCCI edits. 
• Review insurance denials for possible coding correction and claim resubmission. 
• Review the clearinghouse rejections for possible coding errors. 
• Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, and participating in professional societies. 
• Responsible for duties related to billing, including processing, follow-up activities, and providing related assistance. 
• Communicate coding and billing-specific deficiencies to various clinical staff.
• Educate and guide clinical staff on proper documentation and any trends that could cause delays in claim submission. 
• Act as a liaison between coding staff and clinic staff for any coding-related issues or questions.  
• Complete appropriate paperwork/documentation/system entry regarding claim/encounter information.

Skills: Coding Accuracy, Medical Record Review, Compliance Verification, Denial Correction, Rejection Analysis, Professional Development, Billing Support, Staff Education

• Understand the appeals and denial management process.
• Follow up with insurance companies in the U.S. for denied claims.
• Adhere to service level agreements/process benchmark.
• Coordinate with the team members to achieve targets.
• Follow the norms required to maintain quality standards.
• Responsible for effective communication with the end customer as per project requirements.

Skills: Denial Management, Appeals Processing, Insurance Follow-Up, SLA Compliance, Team Coordination, Quality Standards, Customer Communication, Target Achievement

• Analyze the responses (EOBs, COBs) from payers.
• Assess the unpaid claims to make adjustments, as well as make appropriate notes of actions and changes.
• Review the payer’s contracts to clarify claim payment qualification.
• Call insurance to check claim status or follow up on unpaid claims.
• Find out the reason the claims were not reimbursed.
• Research for possible solutions to fix claims to be paid.
• Retrieve all the necessary documents to support the payment requirements.
• Prepare necessary forms to appeal or dispute the denial of claims.
• Resubmit corrected claims through the method of electronic or paper submission.
• Advise clients of the appropriate codes to be used to ensure reimbursement.

Skills: EOB Analysis, Claim Adjustment, Contract Review, Insurance Follow-Up, Denial Research, Claim Correction, Appeal Preparation, Coding Guidance

• Responsible for entering and coding patient services into EMR.
• Prepare out-of-office encounters for hospital charges.
• Prepare and submit clean claims to various insurance companies either electronically or by paper.
• Review clearinghouse reports for rejected claims.
• Work insurance AR to reconcile claims and appeal denied claims.
• Customer Support, answer patient billing questions.
• Assist with in-house billing issues and problems that the patient may be having with ancillary billing.
• Prepare, review, and send patient statements/collection letters.
• Patient collections on unpaid accounts.
• Evaluate patients' financial status and establish budget payment plans.
• Verify patient insurance eligibility/coverage.
• Verify patient coverage for in-house testing/immunizations
• Support co-workers.

Skills: EMR Coding, Charge Preparation, Claim Submission, Rejection Review, AR Management, Customer Support, Patient Collections, Insurance Verification

• Evaluate and resolve claim rejections and denials through internal processes and outbound communication with insurance companies.
• Identify trending issues with payer rejections/denials.
• Communicate effectively with management, other team members, and clients about denial trends affecting insurance payment, including suggested solutions.
• Answer inbound phone calls from patients and insurance companies.
• Assist patients in resolving their account balance, including explaining insurance issues, identifying and obtaining necessary information, and requesting/arranging payment.
• Contribute to the team by taking ownership of existing tasks, accepting new tasks, and seeking ways to improve the process.

Skills: Denial Resolution, Trend Analysis, Communication Skills, Phone Support, Patient Assistance, Account Resolution, Payment Assistance, Process Improvement

• Post charges and payments from EHR or fee slips into to computer daily, using the proper ICD-10 and CPT codes and modifiers.
• Produce pre-logs that balance the total charges and payments on the fee slips.
• Maintain daily log sheets and report totals to the accounting department.
• Post payments received in the mail and/or electronically daily, applying payments to the proper line items using appropriate reason codes.
• Post the appropriate write-offs indicated on the Explanations of Benefits.
• Produce pre-logs that balance to the total payments received, as well as the deposit slips.
• Mark date, location, deposit, and credit card totals on each pre-log before delivery to accounting.
• Produce insurance forms daily.
• Produce statements daily and track the count.
• Maintain accurate demographic information on patients’ accounts.
• Enter the patient's insurance information into the system accurately.
• Verify eligibility and benefit, and explain benefits and cost-share to patients.
• Assist with billing inquiries from physicians, staff, patients, and co-workers.
• Review Explanations of Benefits for the accuracy of reimbursement per contract.
• Report any discrepancy in reimbursement to the manager.
• Follow up on assigned insurance company account receivable, denial follow-up with insurance, process claims, and verify valid referral forms and authorization, maintain AR within the appropriate timely filing per payer, prepare and submit appeal letters and requested records.
• Participate in educational activities, follow up with payers regarding policy changes.
• Review the patient’s accounts aging report and contact the assigned list of patients by telephone and correspondence regarding past due accounts.
• Arrange payment plans, ensure all insurance payments are received, and refer accounts to the collections agency following collection’s protocol.

Skills: Charge Posting, Payment Posting, Eligibility Verification, Coding Accuracy, EOB Review, AR Follow-Up, Patient Communication, Claims Processing

• Review medical claims for accuracy according to CPT, ICD-10, and payer guidelines.
• Submit medical claims electronically and on paper.
• Work with medical offices to resolve documentation errors/missing information.
• Sort and post incoming patient and insurance payments to accounts.
• Create and bill patient responsibility statements.
• Review monthly A/R reports for missing payments, missed denials, and follow up.
• Answer incoming phone calls from patients and/or medical offices.

Skills: Claim Accuracy Review, Claim Submission, Documentation Correction, Payment Posting, Patient Billing, AR Reporting, Denial Follow-Up, Phone Support

• Perform all Billing/Coding functions in the lab billing department.
• Ensure that all outpatient accounts/registrations are accurate to minimize billing time and maximize cash flow.
• Research and initiates review of bills to patients or insurance carriers, as well as sending inquiries to patients regarding inaccurate or incomplete information.
• Code and/or recode accounts by insurance carrier and plan number, and enter into the HIS for billing and/or re-billing purposes.
• Responsible for initiating follow-up to third-party payers and/or patients based on the remittance denial management tool to minimize claim denials and time-out claims.
• Review mail/e-mail correspondence and respond accordingly.
• Daily review/correction/staff education in proper registration procedures.
• Daily review all registration/billing reports to ensure prompt error correction.
• Obtain and document additional insurance and ICD-10 diagnostic codes from MDs' offices when insufficient information is provided.

Skills: Billing & Coding, Account Accuracy, Claim Research, Account Recoding, Denial Follow-Up, Correspondence Review, Staff Education, Information Gathering

• Create claims based on filing codes assigned to medical procedures.
• Submit claims to insurance companies electronically and via mail.
• Send statements to patients for remaining balances after insurance payouts.
• Communicate with insurance company representatives to track payments and confirm patient coverage information.
• Investigate denied claims and outstanding patient invoices to ensure the provider receives payment.
• Manage patient payments and update information over the phone and in person.
• Balance sent claims and payments received to accurately record the provider's monthly and quarterly earnings.

Skills: Claim Creation, Claim Submission, Patient Billing, Insurance Communication, Denial Investigation, Payment Management, Account Updates, Revenue Tracking

• Ensure accurate billing for all Medicare, Medicaid, Commercial insurance, and private pay claims, depending on assigned payers.
• Follow up on delinquent accounts.
• Maintain patient billing files, EMR billing notes, and light typing/correspondence.
• Organize and perform work effectively and efficiently.
• Maintain and promote customer satisfaction.

Skills: Accurate Billing, Claims Follow-Up, Billing Records Management, EMR Documentation, Work Efficiency, Customer Satisfaction, Account Resolution, Payer Compliance

• Data entry of medical charges and claims submittal.
• Accounts receivable follow-up, including written and verbal correspondence with patients and insurers.
• Make adjustments to and rebill patient accounts.
• Research, audit, and investigate proper payment of claims and patient accounts.
• Update patient insurance information, including memo entry for billing documentation.
• Process ERA vouchers and check payments for multiple payors as well as patient payments.

Skills: Charge Entry, Claim Submission, AR Follow-Up, Account Rebilling, Payment Investigation, Insurance Updates, ERA Processing, Patient Payments

• Review charges from the EHR system and use coding software to correct and complete claims.
• Submit claims to payer via EDI/mail.
• Investigate rejected claims from either Practice Management software or the payer, resolve rejection issues, and resubmit claims.
• Discuss billing questions with patients.
• Perform various claims appeals actions, including contacting patients by phone and resubmitting claims to third-party payers.
• Evaluate patient financial status and establish payment plans.
• Monthly report on audit charges.
• Gather patient insurance benefits and prepayment information for office procedures.
• Reviews accounts for possible assignment to collections and makes recommendations to the Business Office Manager.

Skills: Charge Review, Claim Submission, Rejection Resolution, Patient Communication, Claims Appeals, Payment Planning, Audit Reporting, Insurance Verification

• See that patient accounts are processed and submitted to payers.
• Identify billing issues within the Billing System and the clearinghouse, escalate and resolve issues on demand.
• Maintain a professional manner consistent with the group's mission, vision, and values.
• Understand HIPAA, OSHA, Risk Management, and compliance regulations.
• Practice confidentiality in accordance with Company policies and all laws and regulations.

Skills: Account Processing, Claim Submission, Issue Resolution, Clearinghouse Troubleshooting, Professional Conduct, Regulatory Compliance, Risk Management, Confidentiality Practice

• Prepare and enter third-party billings, including Saturday billings.
• Audit superbills and attachments for accuracy, CPT/ICD-10 codes, charges, etc.
• Print, prep, and mail out all paper claims with appropriate attachments.
• Upload and download Electronic batches (claims and ERAs).
• Verify eligibility using RTS on the assigned day for online appointment scheduling (OAS).
• Assist in special projects regarding outstanding AR.
• Stay abreast of regulatory changes to billing and coding procedures and update practices accordingly.

Skills: Third-Party Billing, Superbill Auditing, Paper Claim Processing, EDI Management, Eligibility Verification, AR Support, Regulatory Updates, Coding Compliance

• Timely and accurate coding and billing of medical claims.
• Review insurance claim forms for accuracy and completeness.
• Follow up on unpaid claims and timely resubmission of denied claims.
• Appeal and dispute claims with insurance companies.
• Understand Medical Insurance guidelines and payment methodologies.
• Prepare billing reports and data for the leadership team.
• Upon request, pull documentation and organize for all internal and external audits.
• Review and resolve correspondence and overpayment requests.

Skills: Claims Coding, Claim Review, AR Follow-Up, Claim Appeals, Insurance Knowledge, Reporting Support, Audit Preparation, Overpayment Resolution

• Submit physician claims electronically to PPO, private sector, and government insurances, Tricare, and appeal insurance denials.
• Process payments, monitor accounts receivable, identify and resolve errors and denials, bill secondary insurances, patient co-pays, and deductibles.
• Keep up with billing and coding trends or issues, with billing regulations, guidelines, and requirements, and review with management.
• Strong collection experience with self-pay patients and knowledge of healthcare collection practice.
• Follow up on unpaid claims within standard billing timeframes.
• Respond to incoming telephone calls from patients on time.
• Review accounts to ensure accuracy.
• Provide any account maintenance.

Skills: Claim Submission, Payment Processing, AR Management, Denial Resolution, Coding Compliance, Patient Collections, Phone Support, Account Maintenance

• Review as a second verification basic information for the patient, including name, address, date of birth, social security number, insurance information, and ranking of insurance related to the call, and update on demand.
• Verify receipt of and update PCS information (if non-emergency and/or schedule trips) or payor's preauthorization of services for the trip.
• Verify and update service details, including pick-up and drop-off addresses, date and time, call type, response priority, and transport priority.
• Verify the medical details and determine the appropriate service code, ICD-10, or condition codes for the patient's complaints.
• Verify and update the correct amount to charge for the services rendered and the procedures administered.
• Determine the correct procedure codes and modifiers used for the charges, as required by the payor being billed.
• Report any additional information needed.
• Generate a claim for the trip on paper or in the correct electronic submission format-that includes all the necessary details, modifiers, indicators, condition codes, and documentation, and send to the primary payors.
• Assure HIPAA compliance concerning billing practices.
• Keep track of all trips and claims.
• Ensure ePCRs received are equal to the total trips for that day.
• Maintain knowledge of all coding regulations, particularly as it relates to the assigned state or payer.
• Maintain files for all trips and medical documentation.
• Continuously cross-trains in other functional areas.

Skills: Patient Verification, Insurance Authorization, Service Validation, Coding Accuracy, Charge Determination, Claim Generation, HIPAA Compliance, Trip Tracking

• Perform verbal and written collection activity with insurance carriers for expediting claims reimbursement.
• Compile necessary patient record information for effective appeals.
• Submit appeals using department resources in a timely manner with appropriate documentation.
• Perform consistent follow-up practices with insurance providers.
• Apply discount, bad debt, and other AR adjustments on a timely basis per company policy.
• Review all assigned correspondence and timely responses to ensure proper claim reimbursement.
• Review and entry of daily charges, modifiers, and services.
• Process and post payments, research, and follow up on unresolved payment issues.
• Communicate with offices through calls, e-mails, and visits to review billing concerns.
• Receive and initiate patient calls to resolve billing or payment concerns.
• Research, review, and communicate with insurance carriers regarding open accounts receivable.
• Collect payments from patients and post payments to patients’ accounts.
• Write and maintain all collection notes up-to-date
• Maintain great communication with all offices and assist the front desk with any payment questions that may arise.

Skills: Insurance Collections, Appeal Preparation, Follow-Up Practices, AR Adjustments, Charge Entry, Payment Posting, Patient Communication, Billing Resolution

• Prepare deposits for MWC, PPI, and DCW.
• Prepare refunds for MWC, PPI, and DCW.
• Assist Care Dx with secondaries and any other assistance that they may need regarding billing/collections
• Review all Care Credit payments and post to patients' accounts
• Contact the FFCC collection agency with any patient concerns, posting payment, taking patients out of collections, and maintaining good communications with the agency.
• Work closely with insurance billing, administrative, and front desk staff with regard to verification of demographic and insurance information.
• Review and monitor all reimbursements due from all insurance companies, and determine appropriate collection methods and account follow-up according to the departmental guidelines.
• Responsible for electronic EMR payment posting and batch posting.
• Responsible for insurance payment reconciliation via lockbox, main-concentration account (EFT), and checks received in the mail.
• Responsible for all billing adjustments and refunds.
• Responsible for monthly reports related to accounts receivable and insurance denials
• Pursue insurance carriers by placing phone calls
• Work on the report for the accounts receivable for the billing areas
• Review the Explanation of Benefits received from the insurance companies and take appropriate action, including appealing all claims that are denied or underpaid, requesting adjustments or refunds.
• Advise the business operations manager of any trends related to insurance denials in order to identify problems with particular payors.
• Respond to inquiries from students, parents, and insurance carriers over the telephone and in person, related to insurance billing.

Skills: Deposit Processing, Refund Management, Payment Posting, Collection Coordination, Insurance Verification, Reimbursement Monitoring, AR Reporting, Denial Analysis

• Verify Insurance coverage for new and existing clients and obtain necessary physicians’ referrals and authorizations.
• Verify and confirm the Department of Disabilities Administration Caseload and monthly billing.
• Maintain the organization and completeness of medical insurance billing records
• Communicate effectively with insurance companies, clients, the Director, FRCs, coworkers, and other external agencies via phone and written correspondence.
• Meet with the Director monthly.
• Monitor contracts and increase preferred provider agreements, including paneling and provider credentialing, and identify proper ICD codes, and research for any other requirements
• Maintain knowledge of current coding practices and software.
• Assists in credentialing and maintaining the therapist as an approved provider with insurance companies.
• Communicate effectively with the Executive Director, FRCs, and SPARC staff.
• Respond to families, staff, and insurance companies within 24 hours of the scheduled workday.
• Attend agency and team meetings.
• Verify and reconcile attendance records for the school district and for billing purposes.
• Maintain Insurance Contracts.

Skills: Insurance Verification, Authorization Management, Billing Records Maintenance, Professional Communication, Contract Monitoring, Provider Credentialing, Coding Knowledge, Attendance Reconciliation

• Post payments and adjustments.
• Verify account balances, to insurance EOB’s submit claims to any secondary, and prepare statements to clients.
• Run billing reports to follow up on aging accounts and provide reports to the Director.
• Reference current billing and follow-up processes and provide suggestions for any revisions.
• Work with FRCs for any family establishing a payment arrangement in place of insurance billing.
• Verify receipt of payments to reconcile accounts.
• Work with the Director, FRCs, Leads, and payment arrangements for household income levels.
• Work with families to fulfill this arrangement.
• Follow up regarding insurance denials, resubmit with corrections or supporting documents.
• Maintain confidentiality within SPARC.
• Assist in answering phones.
• Maintain/Update client data reports.
• Maintain data management and HIPAA compliance within SPARC policies and procedures.

Skills: Payment Posting, Balance Verification, Billing Reporting, Process Improvement, Payment Arrangements, Account Reconciliation, Denial Management, Data Maintenance

• Experience as a medical biller or related healthcare administrative position.
• Medical A/R billing experience.
• Experience with EHR systems.
• Knowledge of HIPAA requirements related to medical records and billing requirements.
• Great attention to detail.
• Self-motivated, fast learner with the right culture-fit.
• Proficient in Microsoft Office (Word, Excel, PowerPoint, Outlook).
• Ability to multitask in a deadline-driven environment.

Qualifications: BA in Healthcare Administration with 2 years of Experience

• Experience working with medical refunds.
• Working knowledge of health insurance.
• Strong attention to detail.
• Proficient in 10-key by touch.
• Understanding of Electronic Response Admittances (ERAs) and Explanation of Benefits (EOBs).
• Ability to prioritize and manage multiple responsibilities.
• Professional with excellent communication and customer service skills.
• Basic computer knowledge (Windows, MS Word, MS Excel, Internet).
• Comfortable with computer use, online resources, and learning new software.
• Committed to superior customer service.

Qualifications: BS in Public Health with 1 year of Experience

• Experience and proficiency with billing software, preferably MEDICAL MANAGER.
• Must be savvy in dealing with insurance companies and accounts receivable items.
• Experience in the collection of patient portions of outstanding medical invoices of unpaid claims.
• Able to effectively collect on outstanding accounts receivable, including calling patients and payers for claims payment.
• Experience within medical billing/collections in a high-volume medical practice.
• Experience from a physician’s office or medical group.
• Experience with commercial insurance.
• High level of accuracy and attention to detail.
• Able to work independently with minimal supervision.
• Effective communication skills, both written and verbal.

Qualifications: BS in Health Information Management with 4 years of Experience

• Paid/working experience as a medical billing specialist.
• Experience in filing and submitting claims electronically.
• Work experience in credentialing.
• Knowledge of CPT and ICD-10 codes.
• Experience working with Medicare/Medicaid and Commercial Insurance.
• Experience working with Denials and Reclaims/EOBs.
• Collection experience/setting up payment arrangements.
• Strong and detailed documentation skills.
• Multi-phone lines experience.

Qualifications: BS in Health Informatics with 3 years of Experience

• Healthcare billing experience in a fast-paced, customer-focused environment, preferably Fertility clinic.
• A passion for women's health and fertility.
• Strong written and verbal communication skills, and a team player.
• Willing to be flexible, roll with the punches, multitask, and troubleshoot problems.
• Detail-oriented with strong organizational skills.
• Amazing customer service skills and professionalism.
• Experience in CPT and ICD-9 coding and familiarity with medical terminology.
• Ability to manage relationships with various insurance payers.
• Experience in filing claim appeals with insurance companies to ensure maximum entitled reimbursement.
• Certificate from an accredited medical and billing school.

Qualifications: BA in Medical Administrative Management with 2 years of Experience

• Demonstrated hospital or medical practice claims billing experience.
• Working knowledge of Medical Terminology, ICD-10, and CPT coding.
• Working knowledge of Hospitalist billing
• Strong communication skills.
• Strong analytical and critical thinking skills. 
• Certified Professional Biller (CPB) designation through AAPC.
• Certified Revenue Cycle Specialist (CRCS) designation through AAHAM or Certified Revenue Cycle Associate (CRCA) designation through SCHFMA. 
• Ability to organize and prioritize work and manage multiple priorities.
• Ability to work independently with minimal supervision.

Qualifications: BS in Medical Billing & Coding with 5 years of Experience

• Experience in healthcare billing.
• Knowledge of Medicare, Medicaid, and third-party reimbursement requirements.
• Knowledge of bookkeeping and accounting procedures.
• Ability to exercise independent judgement and provide knowledge and skills to billing.
• Ability to work effectively with individuals.
• Ability to deal effectively with high levels of stress.
• Strong customer service skills for interacting with third parties relating to patient accounts.

Qualifications: BA in Office Management with 3 years of Experience

• Knowledge of CPT, HCPCS, ICD-10 codes, and medical terminology.
• Knowledge of CMS 1500, UB04 claim filing requirements.
• Ability to use business equipment and machines, i.e., copier, credit card, fax, phones, postage, etc.
• Ability to work both independently and in a group setting.
• Proficient in 10-key data entry and typing.

Qualifications: BS in Biology with 1 year of Experience

• Relevant experience in a medical clinic.
• Understanding of the billing process for private and public health insurance programs.
• Skilled in Microsoft Office (Word, Excel, Outlook) and eClinicalWorks (EHR system).
• Ability to gain proficiency in additional computer programs required to perform the job.
• Good verbal and written communication skills, including spelling and English grammar.
• Ability to understand and complete oral and written instructions.
• Prior medical billing experience with FQHC.
• Customer service skills and experience.

Qualifications: BA in Business Administration with 2 years of Experience

• Comprehensive knowledge of health in outpatient settings.
• Excellent people skills, with an ability to partner with a dynamic leadership team.
• Possess personal qualities of integrity, credibility, and commitment to corporate mission.
• Flexible and able to multitask, can work within an ambiguous, fast-moving environment, while also driving toward clarity and solutions, and demonstrated resourcefulness in setting priorities.
• Current knowledge of policies and procedures as they relate to safe work practices.
• Ability to follow all safety procedures and report unsafe conditions.
• Ability to work with a diverse population.
• Willing to work flexible hours, including evenings.
• Must be self-directed and work productively with minimal supervision.
• Ability to work effectively as a member of an interdisciplinary team
• Demonstrated proficiency in using Microsoft applications such as Word, Excel, Access, and Outlook.
• Knowledge of Electronic Health Records.

Qualifications: BA in Medical Office Administration with 4 years of Experience

• Computer experience, including practice management software, word processing, and spreadsheet applications.
• Experience in CPT and ICD-10 coding.
• Familiarity with medical terminology.
• Excellent customer service skills.
• Strong written and verbal communication skills.
• Ability to manage relationships with various Insurance payers.
• Experience in filing claim appeals with insurance companies to ensure maximum entitled reimbursement.
• Experience working with confidential information.
• Ability to perform to the company standards of compliance with policies and procedures.
• Ability to multitask and work courteously and respectfully with fellow employees, clients, and patients.
• Proven ability to meet deadlines.

Qualifications: BS in Health Services Administration with 3 years of Experience

• Medical billing-related experience in a physician's office or graduation from a medical billing program.
• Must have excellent expressive and written communication skills.
• Must be proficient in MS Word and Excel.
• Must be computer-literate.
• Knowledge of medical insurance policies, reimbursement, and medical terminology.
• Experience with insurance websites.
• Good organizational skills.

Qualifications: BA in Finance (Healthcare Billing Emphasis) with 1 year of Experience

• Experience in medical billing.
• Technology savvy with solid computer experience.
• Neat, professional appearance and demeanor.
• Ability to develop productive working relationships and work in a team environment.
• Excellent time management skills with the ability to prioritize and multitask to meet deadlines.
• Ability to perform assigned tasks independently.
• Knowledge of medical and insurance terms.
• Experience with ICD-9, 10, and CPT codes.
• Experience dealing with insurance companies and managed care plans.
• Experience with alpha-numeric data entry - 40 WPM.
• Must have a working knowledge of Word, Excel, Outlook, and the MS Office suite.
• Coding Certification via PMI, AAPC, or AHIMA.
• A background in cardiology, radiology, and/or anesthesiology specialties.

Qualifications: BA in Health Studies with 5 years of Experience

• Experience as a Data Entry Clerk.
• Understanding of Medical Insurance Terminology.
• Excellent computer skills, 10-key, and typing.
• Excellent communication skills.
• Ability to perform all assigned duties with minimal supervision.
• Ability to adhere to all FCCHMG policies and guidelines.
• Knowledge of claims and billing regulations, and medical terminology.
• Good public relations and interpersonal relations skills.
• Ability to pay close attention to detail.
• Evidence of strong ethical standards and moral character; strong work ethic, high energy level, creativity, and teamwork.
• Ability to exercise initiative and good judgment in problem-solving and decision-making, and the ability to mediate and resolve conflicts successfully.
• A high degree of sensitivity to the individual needs of people at all levels within the organization.

Qualifications: BS in Applied Health Sciences with 2 years of Experience

• Working knowledge of medical terminology.
• Basic math skills.
• Strong organization skills with attention to detail.
• Ability to prepare compounds.
• Ability to maintain records and files.
• Ability to work with precision and maintain confidentiality.
• Ability to pass the annual departmental examination.
• Knowledge and understanding of the credentialing process.
• Excellent verbal and written communication skills, including letters, memos, and emails.
• Ability to research and analyze data.
• Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.
• Proficient use of Microsoft Office applications (Word, Excel, Access) and internet resources.
• Proficient use after the training period in OncoEMR and Advanced MD.

Qualifications: BA in Organizational Management with 3 years of Experience

• Experience in medical billing or within the revenue cycle.
• Experience with high-volume data entry.
• Customer service experience.
• NextGen experience.
• Comprehensive knowledge of medical billing.
• Patient Payments experience.
• Previous experience with an electronic medical record system.
• Deep knowledge of explanation of benefits (EOBs).
• Advanced Microsoft Office skills.
• Strong communication and interpersonal skills.

Qualifications: BA in Human Services with 4 years of Experience

• Experience as a Medical Biller.
• Proficiency with electronic medical records (EMR).
• Strong knowledge of the Microsoft Office suite.
• Ability to work independently and collaboratively within a team environment.
• Able to multitask and meet tight deadlines.
• Excellent problem-solving skills.
• Excellent written and oral communication skills.

Qualifications: BA in Patient Services Administration with 1 year of Experience

• Knowledge of insurance guidelines, including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
• Competent use of computer systems, software, and 10-key calculators.
• Effective communication abilities for phone contacts with insurance payers to resolve issues.
• Good customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds.
• Able to triage priorities, delegate tasks, and reasonably handle conflict.
• Strong problem-solving skills to research and resolve discrepancies, denials, appeals, and collections.
• A calm manner and patience working with either patients or insurers during this process.
• Knowledge of accounting and bookkeeping procedures.
• Knowledge of medical terminology likely to be encountered in medical claims.
• Able to maintain patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
• Ability to work well in a team environment and multitask.

Qualifications: BS in Data Analytics (Healthcare Specialty) with 3 years of Experience

• Recent Medicare billing experience.
• Inpatient or outpatient billing experience.
• Experience in a hospital or pharmacy environment.
• Knowledge of patient accounting processes.
• General knowledge of office procedures and operations.
• Skill in data entry with minimal errors.
• Ability to communicate effectively in both oral and written form.
• Ability to understand and follow instructions.
• Skill in completing assignments accurately and with attention to detail.

Qualifications: BS in Medical Office Technology with 2 years of Experience

• Medical billing experience for surgical procedures.
• Must have working knowledge of ICD-10 and CPT Codes.
• Working knowledge of billing Medicare, No-Fault, and Workers' Comp.
• Efficient in coding operative reports.
• Strong written and verbal communication skills.
• Ability to prioritize and multitask.
• Basic math skills and proficient analytical skills.
• Excellent organizational skills with attention to detail.
• Exceptional verbal and written communication skills.
• Ability to maintain a positive attitude.
• Must be able to work with others as a team or independently, unsupervised, in a high-volume, fast-paced work environment.

Qualifications: BA in Health Communication with 4 years of Experience

• Experience as a Medical Biller, Third Party Biller, or equivalent experience in a health care setting.
• Working knowledge and prior experience with medical terminology.
• Working knowledge of automated billing systems.
• Proficiency in word processing (i.e., Microsoft Word or equivalent), internet, and email programs.
• Proficiency in keyboarding skills.
• Good verbal and written communication skills; ability to read/write/speak English.
• Ability to exercise and maintain confidentiality, courtesy, and patience in responding to inquiries under stressful conditions.
• Knowledge of HIPAA regulations.
• A medical billing certification program or equivalent.

Qualifications: BS in Clinical Administration with 1 year of Experience

• Payment processing experience from the provider side.
• IDX or GE experience.
• Knowledge of third-party billing policies, procedures, and regulations.
• Knowledge of healthcare coding principles and their use.
• Strong analytical and problem-solving abilities.
• Good customer relations and communications skills.
• Must be well organized and detail-oriented.
• Must be a strong team player.
• Working knowledge of MS Word, Outlook, and Excel.

Qualifications: BS in Business Information Systems with 3 years of Experience

• Experience handling medical billing.
• Knowledge of Explanation of Benefits (EOB)
• Familiarity with Microsoft Excel.
• Experience with collections of past-due claims.
• Experience in a high-volume setting.
• Strong time management and communication skills.
• Ability to work independently and cohesively in a team setting.

Qualifications: BS in Accounting with 2 years of Experience

• Experience in medical billing procedures, including registration, charge entry, payment posting, and claim preparation.
• Good computer skills and knowledge of relevant software (Microsoft Office and Excel).
• Knowledge of CPT, HCPCS codes, and Modifiers.
• Knowledge of medical terminology.
• Knowledge of insurance terminology, capitation, and fee-for-service billing.
• Knowledge of various insurance company requirements for filing insurance claims.
• Experience in the Epic EMR billing system.
• Knowledge of medical coding.
• Strong communication and organization skills with a detail-oriented approach.

Qualifications: BA in Healthcare Administration with 4 years of Experience

• Experience in Medical Billing and Denial Processing for HBO insurance, Claims Process, or Collections.
• Demonstrated expertise and experience in the area of billing, denials review, and accounts receivable processes.
• Knowledge of CPT-4, ICD-0, HCPCS, Medicare/Medical Terminology.
• Exposure to Word, Excel, Data Entry, and Web Browsing.
• POS System experience.
• Strong verbal and written communication abilities.
• Effective interpersonal skills.
• Strong attention to detail.
• Ability to execute quickly and efficiently.
• Effective problem-solving and troubleshooting skills.

Qualifications: BS in Health Information Management with 3 years of Experience

• Experience working with a healthcare provider.
• Experience with healthcare billing and collections.
• Experience with various practice management systems (Advantx, HST, Vision, Amkai, SIS, Cerner, CPSI, Meditech, CEntricity, Allscripts, AdvancedMD).
• Experience with revenue cycle management and follow-up.
• Experience with facility and/or professional revenue cycle experience.
• Proficient with MS Outlook, Word, and Excel.
• Ability to work independently and as part of a team.
• Strong attention to detail and speed while working within tight deadlines.
• Exceptional ability to follow oral and written instructions.
• A high degree of flexibility and professionalism.
• Excellent organizational skills.
• Strong interpersonal and persuasive abilities to secure accurate and timely payment from patients.
• Ability to work in a fast-paced environment.

Qualifications: BS in Health Informatics with 5 years of Experience

• Experience in billing and collections in a medical setting, or comparable education.
• Experience in healthcare insurance billing and verification, collections, and/or authorizations.
• Knowledge of medical terminology and Knowledge of CPT/ICD-10.
• Strong interpersonal and organizational skills.
• Strong Microsoft Office skills in Teams.
• Comfortable with electronic and manual payor follow-up.
• Able to quickly identify trends and escalate on demand.

Qualifications: BS in Medical Billing & Coding with 2 years of Experience

• Recent critical access or acute care facility billing experience.
• Medicare billing experience.
• Experience in CPT and ICD-10 coding.
• Ability to communicate with various insurance payers.
• Experience in filing claim appeals with insurance companies to ensure maximum reimbursement.
• Ability to read, analyze, and interpret insurance plans, financial reports, and legal documents.
• Excellent customer service skills.
• Ability to work in a fast-paced environment with the ability to solve problems.

Qualifications: BA in Business Administration (Healthcare Focus) with 4 years of Experience

• Experience in healthcare customer service, billing systems, or other related experience.
• Experience working with multiple payer types such as commercial, governmental, Medicare, Medicaid, and HMO.
• Knowledge of medical billing and practice management systems.
• Experience with CPT, ICD-10, and NCCI coding.
• Understanding of co-pay, coinsurance, and deductibles.
• Outstanding communication skills, both verbal and written.
• Positive role model for other staff and patients by working with them to promote teamwork and cooperation.
• Ability to apply commonsense understanding and logic in day-to-day activities.

Qualifications: BS in Public Health with 3 years of Experience

• Physician Billing experience, including insurance carrier follow-up and customer service.
• Strong knowledge of medical insurance and healthcare billing.
• Proven competency in accounts receivable systems and associated applications.
• Ability to communicate effectively with insurance carriers, patients, and co-workers.
• Excellent verbal, written, and social skills.
• Natural curiosity to pursue issues and increase expertise.
• Strive to make an impact on improving business processes and results.
• Strong proficiency with Microsoft Office applications, specifically Word, Outlook, and internet applications.

Qualifications: BA in Medical Office Administration with 2 years of Experience