Pediatric Medical Biller
- Research charge processing and coding issues; review classification situations to determine the most appropriate codes.
- Enter/Correct patient demographics.
- Work accounts in a timely and accurate manner, performing quality assurance for charges.
- Follow up on unpaid claims within standard billing cycle timeframe
- Check each insurance payment for accuracy and compliance with contract discount
- Call insurance companies regarding any discrepancy in payments if necessary
- Identify and bill secondary or tertiary insurances
- Research and appeal denied claims.
- Review patient bills for accuracy and completeness and obtain any missing information
- Answer all patient or insurance telephone inquiries pertaining to assigned accounts
- Set up patient payment plans and work collection accounts
- Other duties as assigned
Knowledge, Skills, and Abilities
- Knowledge of insurance guidelines, including Commercial HMO/PPO and Medicaid
- Use of computer systems and software
- Effective communication abilities for phone contacts with insurance payers to resolve issues
- Customer service skills for interacting with patients regarding medical claims and payments
- Able to work in a team environment
- Problem-solving skills to research and resolve discrepancies, denials, appeals and collections
- High School diploma required
- Minimum of two to five years in a medical office setting
- Pediatric experience preferred
- Strong verbal and written communication skills
- Medical billing/coding certification preferred