Explore the essential duties of a medical biller, including coding, claim submission, payment processing, and patient communication, to enhance your resume and showcase your expertise in healthcare billing.
Must be experience with eClinic system
Patient Information Management: Accurately collect and maintain patient information, including demographics, insurance details, and medical histories, ensuring all data is up-to-date and compliant with regulations.
Insurance Verification: Conduct thorough verification of patient insurance coverage prior to services rendered, confirming eligibility and benefits to minimize claim denials and ensure proper billing.
Medical Coding: Assign appropriate medical codes (ICD, CPT, HCPCS) to diagnoses, procedures, and services provided, ensuring compliance with coding guidelines and regulations to facilitate accurate billing.
Claim Submission: Prepare and submit claims to insurance companies and government payers, ensuring all required documentation is included and claims are submitted in a timely manner to expedite payment.
Claim Follow-Up: Monitor submitted claims for status updates, follow up with insurance companies on unpaid claims, and resolve any issues that may arise during the claims process to ensure timely reimbursement.
Payment Posting: Accurately post payments received from insurance companies and patients into the billing system, reconciling payments with the corresponding claims to maintain accurate financial records.
Denial Management: Analyze and address denied claims by identifying the reasons for denial, appealing decisions when appropriate, and implementing corrective actions to prevent future denials.
Patient Billing: Generate and send patient statements for outstanding balances, providing clear and concise billing information and payment options to facilitate timely payments.
Customer Service: Serve as a point of contact for patients and healthcare providers regarding billing inquiries, addressing questions and concerns with professionalism and empathy to enhance patient satisfaction.
Compliance Adherence: Ensure all billing practices comply with federal and state regulations, as well as HIPAA guidelines, to protect patient confidentiality and maintain ethical standards in billing.
Data Entry and Record Keeping: Maintain accurate and organized billing records, including patient accounts, payment histories, and correspondence with insurance companies, ensuring easy access for audits and reviews.
