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Medical Billing Representative

Company: Edward M. Kennedy Community Health Center, Inc.
Location: Worcester
Posted on: November 10, 2019

Job Description:

Job Summary:Follows department and payer processes to ensure all claims are submitted in a timely and accurate manner. Analyzes and reviews outstanding accounts receivables.-- Prepares appeals and corrected claims within payer guidelines for resubmission in order to maximize reimbursement.Essential Functions:

  • Reviews patient eligibility utilizing practice management function or payer websites to determine correct payer to be billed for specific dates of service.
  • Prepares claim data according to department and payer regulations in order to produce a clean claim.
  • Posts charges, payments and denials in practice management system accurately.
  • Works denials and prepares appeals, resubmits claims and performs compliant actions to resolve open accounts receivable.-- Reports unusual trends to supervisor.
  • Works with payer representative to research and resolve denials issues and obtain payer policy knowledge as necessary.
  • Utilizes insurance and practice management online systems to complete all required tasks such as eligibility, claim status and claim correction.
  • Processes insurance and patient refunds as necessary.
  • Answers patient and department calls.
  • Scans/files all relevant documentation.
  • Ability to work independently and as part of a team.
  • Performs other duties as assigned.Education and Experience:
    • High school diploma or equivalent.
    • 1-2 years of medical billing experience, medical billing certificate, or at least 30 days on-the-job training in EMK billing department

Keywords: Edward M. Kennedy Community Health Center, Inc., Worcester , Medical Billing Representative, Healthcare , Worcester, Massachusetts

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