We are a progressive organisation based in the US and plan to commence our Medical Billing service unit.
On average, we will be receiving 40 medical cases/day, turning out to be approx. 1,000 cases a month, for which activities such as data entry, claim submission, calls and negotiation to/with insurance providers, claim denial management, followups until the claim is processed & paid etc will be carried out by you.
Please review the details below for better understanding.
Medical Billing Services that we expect from the candidate includes the following:-
- To check Eligibility and verification of patient’s health benefits from insurance carrier’s website and through Phone.
- Create appointments on scheduler while receiving patient calls
- Full patient demographics and charge entry
- Insurance claims submission (primary, secondary or tertiary)
- Accounts receivable analysis with corrective and preventive actions and decision making for Collections
- Strong claims follow up on denials from insurances like Workers Comp, Medicare, Medicaid, BCBS Semi Government, Managed care and Commercial Insurances (Aetna, BCBS, Cigna, UHC, Oxford etc...)
- Patient billing inquiries as per received information from provider office
- To check claim status from insurance, websites, auto response unit and via live calls.
- To make on call appeals for reprocessing of incorrectly processed claims based on billing knowledge
- ICD9, CPT and HCPCS Coding and/or review, Encoder pro Expert licensed version guided for correct coding
- Daily, Monthly and annual AR Financial reports preparation
- Custom reports where required
- Patient billing as per instructions
- Credentialing guidelines
- Super bill review
Medical Coding tasks:
- To research the right DX and CPT code according to medical records
- Provide right DX pointers for the first time to avoid payment delays
Note: A good candidate means a permanent position in our organisation. This is an on-going project.
I am looking for a mix of experience and value