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Real Soft, Inc.

Office/Administration - Medical Claims Coordinator/Processor

mason, OH

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Job description

Medical BillerMedical BillerMarkup – 33.05Budgeted Bill Rate: $ th month tenure discount 22.50%Payment Terms – Net 90 days (paid when paid) OIG/GSA and Background screenings required Missing equipment fee if not returned: $ # of positions needed: 2Job Title/Job DescriptionJob Title: Medical BillerWork hours: First Shift – 8 AM – 5 PMBrand: LenscraftersTemp only or temp to perm: Temp to permStart date: ASAPLength of assignment: Not endingLOCATION - hybrid: Remote Monday and Friday; In office Tuesday, Wednesday, ThursdaySpecific Skills NeededMedical Billing, cash application and collection (collection is not calling demanding payment; it's researching why a claim didn't get paid and taking steps necessary to correct the info)Years of Experience: 5 yearsReason for RequestNew business is coming online.General FunctionThe Medical Claims Biller is responsible for monitoring insurance carrier adjudication of TeamVision medical claims for one or more doctor practices. Utilize a practice EHR system and clearing house to review and submit claims to multiple medical insurance carriers. Review open/unpaid claim balances and take required action.Major Duties & Responsibilities• Review medical claims and transmit to the insurance carrier using the practice electronic health records (EHR) system and clearing house.• Monitor rejected claim reports and adjust claims for resubmission to the insurance carrier.• Download insurance carrier explanation of payments (EOPs) to post claim payments and denials in the EHR system.• Determine if denied claims can be corrected and re-submitted to the carrier.• Review aging reports to research open balances and resubmit within insurance carrier filing limits.• Utilize insurance carrier websites and contact carriers as needed to investigate denials and claim status.• Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system.• Initiate overpayment refunds to patients and repayments to insurance carriers when required.• Serve as the point of contact for the practice regarding all vision and medical claims.• Support the corporate manager in maximizing claim collection rate.

Worksite address

mason, OH, 45040, US

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