Medical Biller at Omega Healthcare Management Services in Boca Raton, FL, United States

Job description

• JOB DESCRIPTION

Responsibilities

• Analyzes, investigates, and resolves account issues, including resubmitting and updating line and claim document information.
• Accesses available resources to locate missing or incorrect information. Updates medical claims with corrected billing information and releases claims for transmission to the payer.
• Investigates and documents actions taken to resolve medical billing discrepancies and unusual charges and credits.
• Works high priority Third-Party Liability/MVA/WC cases according to department policies and procedures.
• Conducts research to make the determination of related paid claims for subrogation cases, which includes identification and validation of TPL/MVA/WC claims cost avoidance.
• Receives and responds to incoming correspondence and calls pertaining to TPL/MVA/WC verification, billing, and collections inquiries from various sources.
• Evaluates case status based on established criteria and takes appropriate action to maintain productive and proactive communication with the third party.
• Ensures that all appropriate patient service charges are entered into the billing system.
• Performs other duties as directed.
• Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance.

Requirements

• Ability to prioritize and multi-task in a fast-paced, changing environment.
• Demonstrate ability to work in all work types and specialties.
• Demonstrate ability to self-motivate, set goals, and meet deadlines.
• Demonstrate leadership, mentoring, and interpersonal skills.
• Demonstrate excellent presentation, verbal, and written communication skills.
• Ability to develop and maintain relationships with key business partners by building personal credibility and trust.
• Maintain courteous and professional working relationships with employees at all levels of the organization.
• Demonstrate excellent analytical, critical thinking and problem-solving skills.
• Skill in operating a personal computer and utilizing a variety of software applications.
• Knowledge of coding convention and rules established by the AHIMA, American Medical Association (AMA), the American Hospital Association (AHA) and the Center for Medicare and Medicaid (CMS), for assignment of diagnostic and surgical procedural codes.
• Knowledge of JCAHO, coding compliance and HIPAA HITECH standards affecting medical records and the impact on reimbursement and accreditation.
• Successful completion of an AAPC or AHIMA-approved Coding Certificate Program and a minimum of three to five years of medical billing and/or coding experience. Experience with Workers Compensation and Third-Party Liability/MVA billing and collections. Experience with Third Party Liability/Attorney collections.
• Must have the following certificates and/or licenses: CPC, COC, CIC, RHIA, RHIT, CCS, and/or CCS-P.
• Successful completion of an AAPC or AHIMA-approved Coding Certificate Program and a minimum of three to five years of medical billing and/or coding experience. Must have the following certificates and/or licenses: CPC, COC, CIC, RHIA, RHIT, CCS, and/or CCS-P. Experience with Workers Compensation and Third-Party Liability/MVA billing and collections. Experience with Third Party Liability/Attorney collections. Excel and Epic Experience
• N/A

Skills

Required

• Excel and Epic Experience