Billing Agent

POSITION TITLE: Medical Billing Agent

Whatley Health Services, Inc. is seeking a qualified Medical Billing Agent to join our team. Responsible for completing denial management and Accounts Receivable (AR) follow-up for outstanding claims. Additional responsibilities include identifying and preparing insurance refunds, completing necessary claim corrections, and reviewing claims for any necessary adjustments.

QUALIFICATIONS:

• High school diploma or GED required. Medical billing and coding certification preferred.
• Minimum of one year experience in revenue cycle management; insurance claim follow-up required.
• Prior experience with EMR/EHR/Practice management systems and payor websites.
• Knowledge of insurance and medical terminology.
• Experience reading and understanding insurance benefits.
• Must have excellent patient/customer services skills, detail oriented and computer efficiency.
• Ability to work independently and work with a team to resolve issues.

SUMMARY OF DUTIES:

• Prepare and submit insurance claims to insurance companies and government agencies for reimbursement.
• Respond to inquiries from insurance companies, and health facilities regarding billing issues, claims status, and insurance coverage.
• Follow up on unpaid or denied claims, in a timely manner.
• Complete necessary claim corrections, reconsiderations, and/or appeals for outstanding claims.
• Read EOB’s, remittances, and payer correspondence as part of account follow-up and escalate any identified issues to the appropriate area for review and response to expedited claim resolution.
• Prepare documentation for insurance overpayments and patient refunds.
• Promptly respond to patient phone calls. Work with patients and guarantors to resolve payer requests and discrepancies to promptly resolve pending claims.
• Document interactions associated with patient accounts.
• Ensure compliance with healthcare regulations and billing guidelines, such as HIPAA, CMS and HSRA regulations.