Medical Billing Associate

Working Hours-Day Shift (12 pm-9:30 pm)-(Mon-Fri)

Sound knowledge of HMO/PPO, Medicare, Medicaid, and other payer requirements and systems. Knowledge of HCPCS, CPT, and ICD-10 coding

• Identify discrepancies or trends and perform root cause analysis on unpaid, over paid, and underpaid claims.
• Understand payment posting process and requirements for all forms of payment including electronic remittance, lockbox, and patient payments.
• Accurately enter interest activity and insurance retractions or withhold payments.
• Accurately utilize and enter the appropriate payment codes, adjustment codes, denial reasons, and remark codes received from the explanation of benefits or other source documents.
• Consistently enter accurate transactional data as compared to the explanation of benefit payment details and ensure the entered batch totals balance to the remittance or check.
• Research incomplete explanation of benefit detail for withholds, credits or other pertinent data.
• Prepare daily spreadsheet and complete payment posting and reconciliation while documenting appropriate supporting details.
• Develop and maintain positive working relationships with clinical personnel, co-workers, and insurance representatives.
• Maintain an appropriate professional appearance and demeanor in accordance with company policies.
• Keep commitments and keep direct supervisor informed of work progress, timetables, and issues.
• Maintain strict compliance with State, Federal and other regulations (e.g., OSHA, WC, HIPAA, ADA, FEHA, DOL, HR policies and practices).

Other duties as assigned by management