About the role
Manage the full medical billing cycle, including claim submission, payment posting, follow-up, and collections.Prepare, review, and submit accurate electronic and paper claims to Medicare, Medicaid, and commercial insurance carriers.Verify patient insurance eligibility, benefits, and authorizations when required.Monitor and follow up on outstanding accounts receivable to ensure timely reimbursement.Investigate and resolve claim denials, rejections, and underpayments.Prepare and submit corrected claims and appeals as necessary.Review and interpret Explanation of Benefits (EOBs) and payer correspondence.Maintain accurate documentation and billing records in accordance with company policies.Collaborate with internal departments to resolve billing discrepancies and improve reimbursement processes.Ensure compliance with HIPAA regulations and payer-specific guidelines.Stay updated on changes in billing regulations, coding requirements, and insurance policies.
Minimum 5 years of experience in US Medical Billing.Strong knowledge of the US healthcare system, including Medicare, Medicaid, and commercial insurance plans.Proven experience with claims follow-up, accounts receivable management, denial resolution, and appeals.Proficiency in reviewing EOBs and identifying payment discrepancies.Working knowledge of CPT, ICD-10, and HCPCS coding systems.Experience using medical billing software and EMR/EHR systems.Excellent English communication skills, both written and verbal.Strong analytical, organizational, and problem-solving abilities.High attention to detail and ability to manage multiple priorities in a fast-paced environment.Proficiency in Microsoft Office applications, especially Excel.Preferred Qualifications:Home Infusion billing experience is strongly preferred.Experience billing infusion therapies, specialty medications, and related supplies and services.Familiarity with prior authorizations and payer requirements specific to Home Infusion services.Certification in Medical Billing or Coding (CPB, CPC, or equivalent) is a plus.
