Billing Representative

Essential Functions

• Reviews insurance denials and rejections to determine next appropriate action steps and obtain necessary information to resolve outstanding denials and rejections.
• Verifies patient demographic information and insurance eligibility, including coordination of benefits, and updates information as needed to allow claim processing.
• Verifies receipt of claims with insurance plans and determines the next appropriate action step.
• Researches information needed to complete the billing process, including obtaining information from providers, ancillary services staff, and patients.
• Assists patients and family members with billing and account questions, including follow-up with insurance companies and internal departments as needed.
• Maintains productivity standards and ensures timely reimbursement of claims from insurance payers.
• Works accounts receivable insurance balances and helps reduce outstanding balances.
• Analyzes accounts for proper claims processing and payment posting through inquiries from patients or staff.
• Communicates with insurance and collection agencies and works through account balance obstacles to maximize reimbursement.
• Identifies and communicates trends and potential issues to the Billing Supervisor.
• Follows and maintains all company policies and procedures, including billing-related procedures.
• Maintains accounts receivable by identifying potential problems related to registration, charge corrections, duplicate accounts, and refunds.
• Understands the accounts receivable posting process for medical billing, including charges, payments, and adjustments.
• Demonstrates current competencies required for the position.

Work Environment

• Normal office environment.
• Sitting and standing as part of normal office duties, with some bending and stretching required.
• Manual dexterity required for use of calculator and computer keyboard.