Third Party Medical Biller – HealthDrive – Framingham, MA

Overview:

*** $500.00 SIGN ON BONUS ***

The Third Party Medical Biller is responsible for accurately and timely processing of assigned billing duties on a daily basis with the primary goal of sending a clean claim the first time to increase cash collections and reduce DSO.

Responsibilities:

• Review, prepare and accurately bill for assigned charges on a daily basis
• Perform manual billing for hardware orders from dispense paperwork within 24 hours of receipt
• Identify and communicate billing corrections to providers and perform follow-up to ensure corrections are processed in a timely manner within established guidelines
• Review, communicate and work with providers to resolve unbillable orders due to documentation not fully completed by providers and any other issues impacting the ability to bill for the charges in timely manner
• Update data for assigned tasks on daily productivity tracking spreadsheet
• Meet or exceed daily productivity objectives for all assigned duties
• Process all billing and mail items on a daily basis in order to achieve cash collections and DSO objectives including but not limited to:
  • Process insurance changes from daily insurance spreadsheet on a daily basis, updates are to be completed within 48 hours of receipt
  • Review explanation of benefits from insurance payers for issues requiring follow up and resolution includes but is not limited to the following:
    • Claims denied for unable to identify patient /patient not covered on date of service
    • Conduct timely follow-up with insurance payers, patients, facilities to obtain corrected/updated billing information
    • Research incoming mail received with updated billing information or returned for incorrect mailing address and make required updates in billing system
    • Utilize insurance eligibility websites as needed to verify new insurance information received from patient, RP or facility prior to rebilling
  • Respond to email inquiries regarding billing related questions/issues within 24 hours.
  • Administrative tasks including but not limited to:
    • Assist with mailings, filing, processing refunds and document scanning
    • Other duties and tasks may be assigned as appropriate or necessary

Qualifications:

Associate’s Degree preferred plus a minimum of 5 years experience in 3rd party medical billing and/or collections. Experience and knowledge of healthcare and medical terminology, including but not limited to: CPT, ICD9 /ICD10 codes and use of modifiers. Experience in billing Medicare Part B, Medicare Replacement plans and Medicaid for large multispecialty physician practice preferred.