Certified Medical Biller

JOB TITLE: Certified Medical Biller

TYPE: Non-exempt, Hourly

SCHEDULE: Full- time, Monday through Friday, 8:00 a.m. to 5:00 p.m.

REPORTS TO: RCM Team Manager and Director of RCM Services

JOB PURPOSE: The Certified Medical Biller will be responsible for completing assigned tasks for Zenith Healthcare Solutions clients including, but not limited to, the following job duties:

JOB DUTIES: • Create invoices for services provided by clients within their electronic medical record (EMR) system or practice management (PM) system. • Ensure appropriate charges are applied to invoices within the EMR/PM system for services provided by clients. • Ensure appropriate CPT, HCPCS, and ICD-10 codes are billed by clients • Post payments from third party payers and patients that are collected and scanned into the EMR/PM system by clients within a specified timeframe. • Download ERA/ERN files to client server from client’s clearinghouse. • Ensure accurate and timely auto-posting activity in client’s EMR/PM system using ERA/ERN files downloaded from client’s clearinghouse. • Review auto-posted activity to ensure accuracy. Correct information incorrectly posted. • Processes rejections and denials within a specified timeframe for clients. • Determine if claims need to be re-filed or submitted for an appeal for clients. • Review and respond appropriately to appeal requests for third party payers within the time frame required by the payer. • Make routine inquiries on filed insurance claims to determine status with updated notes within the client’s EMR/PM system. • Routinely work insurance and patient collections as defined by Zenith Healthcare Solution’s Policies and Procedures. • Verify patient insurance benefits and eligibility. Assist client determine time of service (TOS) financial responsibility. • Document work performed and action taken within client EMR/PM system. • Review patient information in client EMR/PM system to determine if adjustments made on accounts are valid and whether additional approval is required. Processes all approved adjustments. • Request additional information if necessary from client to ensure timely payment of all insurance claims. • Answer patient phone calls concerning balances and adjudicated insurance claims posted into client’s EMR/PM system. • Communicate with designated client representative (usually office manager) concerning topics related to billing and collection as directed by RCM Team Manager. • Other related job duties that may be assigned from time to time to assist clients with revenue cycle management projects and tasks. • JOB REQUIREMENTS: • Certified Medical Biller • High school diploma or GED • Strong verbal and written communication skills. • Previous 3-5 year experience in medical billing and collections. • Experience with EMRs/PMs and clearinghouses • Ability to work effectively with a team to achieve goals and complete tasks. • Knowledge of common medical billing and coding practices. • Strong understanding of medical terminology and ability to use in daily tasks.

Job Type: Full-time

Benefits:
• Dental insurance
• Health insurance
• Life insurance
• Paid time off

Schedule:
• Monday to Friday

Experience:
• Medical billing: 4 years (Required)

Work Location: Remote

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