Medical Biller/AR Specialist

We are seeking a detail-oriented Medical Biller/AR Specialist to join our dynamic team. As a Medical Biller/Specialist, you will play a crucial role in ensuring the accurate and timely processing of medical claims, facilitating efficient reimbursement, and maintaining compliance with healthcare regulations. You will work closely with healthcare providers, insurance companies, and patients to manage the billing and revenue cycle, contributing to the financial health of our organization.

Responsibilities:

• Review high volume of claims to ensure they meet billing guidelines.
• Submit high volume of electronic claims accurately and timely.
• Submit claims to secondary insurance with appropriate supporting documents.
• Effectively review EOB denials and underpayments to determine best course of action (resubmission/appeals).
• Perform follow ups and obtain claims status through insurance portals and over the phone.
• Perform verification of benefits and obtain authorizations when required.
• Maintain productivity and quality levels set by management.
• Adheres to all HIPPA and PHI guidelines.

Qualifications:

• Knowledge of medical terminology, CPT codes, ICD-10 codes, and modifiers.
• Experience with commercial insurance, Medicare, and Medi-cal.
• knowledge of EOBs and ERAs.
• Excellent communication and analytical skills.
• Attention to detail and strong organizational skills.
• Toxicology billing experience a plus.
• Medical billing certification a plus.
• Coding experience a plus.