Biller & A/R Specialist at 365 Medical Billing Services LLC – Pittsford, Michigan

365 Medical Billing Services

Biller and A/R Specialist

Advanced Opportunities: Billing Supervisor

Reports to: Billing Supervisor

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Job Description

A 365 Medical biller and A/R specialist is responsible for sending out and following up on bills with Insurance Companies, TPA's, patients and Attorneys. This is to include sending claims via email, mail, electronically, or fax and following up on to verify that claims have been received via email or phone. They work closely with Insurance Companies, TPA's, adjusters, attorneys, and patients to successfully receive payment for services rendered and to fight for payment when a denial is received.

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Functions of this position will be (not all encompassing):

• Receive tasks from intake requesting a claim to be billed out
• Ensure all patients accounts have been updated with the correct information/documents
• Review documentation on insurance information for accuracy and to verify who we are billing is correct prior to sending bill
• Verify the HCPC's, ICD10's, fee schedules, purchase orders (if applicable) are accurate before submitting claim
• Create a HCFA 1500, upload 1500 to Tebra, create a bill file if needed, and send bills via fax, email, electronically or mail
• Note accounts regarding all information on the patient and the bills that have been submitted
• Follow up on sent out bills by contacting the insurance company, TPA or Attorney via email or phone
• Request and receive EOB's (Explanation of Benefits) regarding payments or denials
• Create or ask for a Request for Reconsideration on all denials. This can be completed by calling the insurance company, adjuster or TPA or by creating an appeal letter and sending to the billed company via fax, email, or mail
• Create and mail patient statements
• Negotiate with attorneys, insurance companies or negotiation services to get our bills paid
• Create Aging reports and send over to TPA's to follow up on payments
• Use aging reports to follow up on all unpaid claims monthly in each account
• Work Clearinghouse rejections if applicable
• Review Patient accounts to verify payments have been applied and complete tasks associated with the bill once payment has been received
• Performs other duties as they arise, or the need is relevant to the business