Claims Billing Representative

Position Summary:

The Claims Billing Representative I produce and submits claims to insurance companies, performs

collection calls, answers patients’ billing questions, and ensures records are kept in accordance with policies and procedures.

Remote work after successful completion of training is an option! Must live within 2 hours driving distance to our location in Middleton. We provide the equipment to do your job from home! We offer competitive benefits; PTO is accrued from the day you start offering 3+ weeks a year!

Technical Responsibilities:

• Contributes to Operations/Billing meetings.
• Develops and maintains detailed guidelines in order to bill accounts.
• Is responsive to coaching/adjustments.
• Identifies and reports problems causing inefficiencies in processes.
• Thoroughly reviews patient notes to ensure claims are billed correctly.
• Processes insurance claims correctly and promptly.
• In case of billing errors, performs credit/rebills.
• Understands insurance billing and follow-up processes in order to effectively communicate with callers.
• Handles phone contact with questions from insurers or providers appropriately.
• Coordinates with supervisor regarding hardware/software issues.
• Maintains and files patient records accurately.
• Facilitates prompt resolution of outstanding account balances (including credit balances) through appeals, follow-up, and other means to ensure timely and accurate collections.
• Prioritizes accounts to maximize collections.
• Proficient in researching and resolving delinquent accounts to ensure timely collections.
• Submits appropriate documentation for adjustments, write offs or bad debt to manager/supervisor.
• Notifies supervisor of problem accounts.
• Clearly communicates with patients, guarantors, and/or other interested parties regarding questions about their bill, concerns about their ability to pay, and/or complaints about services in a courteous, kind, and professional manner.
• Refers patients with delinquent balances to collections agency and assists in filling paperwork with the court in the event of deceased patients with outstanding balances and open estates.

Education:

High school diploma or equivalent

Experience:

Minimum of two years reimbursement and/or insurance experience preferred. Infusion, home health, or DME experience preferred. Strong interpersonal, communication and organizational skills needed.