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What you'll do
Manage full cycle billing, including the submission of claims, follow-up, and payment posting
Accurately enter patient demographics, insurance information, and charges into billing software
Review medical claims for accuracy and completeness, ensuring compliance with coding standards (ICD-10, CPT, HCPCS) to avoid rejections
Review rejections and file corrected claims
Submit claims to insurance companies electronically and via paper, as needed
Follow up on unpaid claims and research denials to ensure proper reimbursement
Post insurance and patient payments, applying adjustments and corrections when necessary, and bill patients appropriately
Interpret and process Explanation of Benefits
Reconcile accounts receivable and resolve discrepancies
Handle patient inquiries related to billing, insurance coverage, and payment plans
Collaborate with healthcare providers and office staff to ensure smooth billing operations
Stay current on insurance regulations, industry standards, and updates to billing codes
Maintain accurate records and documentation of billing activities and provide weekly updates
Interact professionally with medical offices and their patients on behalf of ModuleMD providing information about their insurance payments and claims processing
Provide medical offices with education on best practices in billing to improve overall success
High school diploma or equivalent; Associate’s degree in healthcare administration, business, or related field (preferred)
Certified Professional Biller (CPB) or Certified Medical Reimbursement Specialist (CMRS) certification (preferred)
Minimum of 2-3 years of experience in medical billing, with a focus on full cycle billing
Strong knowledge of ICD-10, CPT, and HCPCS codes, as well as insurance and government payer guidelines
Proficiency in medical billing software (e.g., Kareo, Athenahealth, Trizetto or similar platforms)
Excellent attention to detail and accuracy
Strong problem-solving skills and ability to resolve billing discrepancies
Ability to work independently and within a team in a fast-paced environment
Strong communication and customer service skills
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