Claims Coordinator (Medical Biller) @ Paramus, NJ 07652 (Hybrid)

Claims Coordinator (Medical Biller)

Location : Paramus, NJ 07652 (Hybrid 2x / week onsite)

Duration : 6 months possible extension / Temp-to-Perm

Work Hours : 9 : 00 AM 5 : 00 PM

Pay Rate : $21.43 / hr. W2 All Inclusive

Start Date : Immediately

# of Positions : 1

GENERAL FUNCTION

The Medical Claims Biller is responsible for monitoring insurance carrier adjudication of TeamVision medical claims for one or more doctor practices. Utilize a practice EHR system and clearing house to review and submit claims to multiple medical insurance carriers . Review open / unpaid claim balances and take required action.

MAJOR DUTIES & RESPONSIBILITIES

• Review medical claims and transmit to the insurance carrier using the practice electronic health records (EHR) system and clearing house .
• Monitor rejected claim reports and adjust claims for resubmission to the insurance carrier.
• Download insurance carrier explanation of payments (EOPs) to post claim payments and denials in the EHR system.
• Determine if denied claims can be corrected and re-submitted to the carrier.
• Review aging reports to research open balances and resubmit within insurance carrier filing limits .
• Utilize insurance carrier websites and contact carriers as needed to investigate denials and claim status .
• Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system.
• Initiate overpayment refunds to patients and repayments to insurance carriers when required.
• Serve as the point of contact for the practice regarding all vision and medical claims .
• Support the corporate manager in maximizing claim collection rate .

BASIC QUALIFICATIONS

PREFERRED QUALIFICATIONS

CANDIDATE SELF-ASSESSMENT QUALIFYING SKILL MATRIX

( For candidate to self-score : Rate your skill level from 1 (Beginner) to 10 (Expert) and provide years of experience + any relevant comments.)

Required Skill

Skill Rating (1 10)

Years of Experience

Notes / Comments

Medical claims billing

Working with EHR systems

Working with clearing house systems

Reviewing & submitting insurance claims

Handling rejected claims

Working with EOPs (posting payments / denials)

Denied claim corrections & resubmissions

Aging report review

Insurance carrier portals & websites

Investigating claim denials

Patient billing statement handling

Overpayment refund processing

Vision & medical claims knowledge

Claim collection rate support

Prioritization & multitasking

Communication skills (verbal, written)

Preferred Skill

Skill Rating (1 10)

Years of Experience

Notes / Comments

Multiple doctor practice billing

Working with multiple insurance carriers

Understanding insurance claim requirements

Problem identification & resolution