Function as a subject matter expert in support of other billing team members.
Demonstrate a good understanding of payer benefits requirements, claims status, submissions of claims, insurance follow-up, payment posting, and reconciliation procedures.
Approve or deny requested adjustments and refunds within role thresholds.
Manage and resolve denied, adjusted, or underpaid procedures on insurance accounts to reduce Accounts Receivable.
Prepare and submit electronic and paper claims to insurance companies.
Collaborate with multiple clinics and providers to rectify demographic errors.
Communicate effectively with insurance companies, adjusters, and third-party payers via phone, email, and other channels.
Analyze insurance EOBs to ensure correct payment for all procedures.
Identify trends and issues with various payers and propose solutions for resolution.
Process and post insurance payments promptly.
Submit insurance claims to payers in a timely manner, adhering to compliance regulations.
Ensure compliance with relevant state and federal agencies.
Ensure quality and productivity standards are met or exceeded.
Perform other related duties as assigned.
A minimum of 3 years�� experience as a medical biller, collector, or a similar role.
Adapt to process and procedure evaluations and improvements, support continuous change, and willingly manage special projects in addition to normal workload and other duties as assigned.
Adaptability to change and ability to prioritize tasks effectively in a fast-paced environment.
Proficiency with office management tools, particularly Microsoft Office software.
Exceptional organizational and time-management skills.
Outstanding written and oral communication abilities.
Detail-oriented and problem-solving mindset.
Ability to translate and analyze data into reports.
Excellent interpersonal and supervisory skills.
Ability to act with discretion, tact, and professionalism in all situations.
Ability to maintain records and produce reports.