Medical Billing Representative (225-1012)

A Medical Billing Representative plays a crucial role in maintaining the financial health of a healthcare facility by ensuring accurate and timely billing for services provided to patients. This professional is responsible for processing insurance claims, managing patient billing information, and providing excellent customer service to patients regarding their billing concerns. The Medical Billing Representative works closely with healthcare personnel to ensure that all billing records are up-to-date and comply with federal and state regulations. They also handle discrepancies and resolve issues related to billing and payments, which requires a solid understanding of medical coding and insurance procedures. Their role is essential for maximizing the financial performance of the healthcare provider while maintaining positive patient relations.

Responsibilities

• Prepare and submit insurance claims for reimbursement in a timely manner.
• Verify and update patient insurance information to prevent claim rejections.
• Monitor accounts to identify overdue payments or payment discrepancies.
• Follow up with insurance companies regarding unpaid or denied claims.
• Communicate with patients to address billing questions and resolve issues.
• Maintain accurate and organized records of patient billing information.
• Collaborate with medical staff to clarify and resolve any billing discrepancies.
• Ensure compliance with relevant federal and state billing regulations.
• Use medical billing software to enter and process billing data efficiently.
• Prepare reports on billing activities for management review and analysis.
• Provide support in coordinating payment plans for unresolved patient balances.
• Keep abreast of changes in insurance coverage and billing procedures.

Requirements

• High school diploma or equivalent; certification is a plus.
• Proven experience working in medical billing or healthcare reimbursement.
• Strong knowledge of medical coding systems such as CPT and ICD-10.
• Familiarity with insurance claims processing and reconciliation procedures.
• Excellent communication skills to interact effectively with patients and staff.
• Detail-oriented with the ability to ensure billing accuracy and compliance.
• Proficiency in medical billing software and office technology tools.
• Strong problem-solving skills to resolve billing discrepancies efficiently.