Medical Biller

Responsibilities:

• Ensure the submission of accurate claims to insurance companies and other funding sources on time.
• Troubleshoot billing discrepancies and resolve non-payment issues through payment reconciliation.
• Review and correct all claims daily before submission.
• Upload and review EOBs, 277s, 835s, and 999s weekly.
• Reconcile batches and correct claims for resubmission weekly.
• Communicate with ASO to correct or dispute claims that cannot be processed online or via the EMR system.
• Notify providers of insurance lapses and reinstatements, and address authorization issues.
• Communicate with consumers about insurance lapses or issues, entering necessary warnings in the EMR system.
• Work with the psychiatry department on RxEM codes as needed.
• Maintain and manage consumer data and insurance information in compliance with privacy protocols.
• Recognize and report unethical or fraudulent billing practices.
• Update service locations as necessary.
• Manage and update the billing matrix as needed.
• Conduct billing audits as required.
• Process self-pay payments when applicable.
• Obtain concurrent OMHC authorizations.
• Participate in supervision, meetings, and training as required.
• Perform other duties as assigned.