MCVO Opening

Mid-Level Medical Biller

Job Description:

  • Essential Duties and Responsibilities include the following. Other duties may be assigned.
    ● Accept and process all requests from payers for credentialing information/updates/new contracts and products.
    ● Conduct all follow up steps till payor approval/completion is obtained.
    ● Answer questions, process requests from staff/providers related to credentialing information.
    ● Checking eligibility and coordination of benefits verification for Ophthalmic procedures/services.
    ● Perform medical record management, including updating of records and prescriptions.
    ● Coordinate practice training for process improvements.
    ● Reviewing patient bills for accuracy and completeness and obtaining any missing information – Ophthalmic
    services.
    ● Preparing, reviewing, and transmitting claims using billing software (EPM), including electronic and paper claim
    processing.
    ● Submission of billing data to appropriate insurance providers.
    ● Achieve maximum reimbursement for services provided.
    ● Resolve denial instances.
    ● Perform posting charges.
    ● Maintain reports on various projects.
    ● Conduct audits of Practice Management System reports versus Revenue reports.

Key Qualifications:

  • ● Ability to organize, set priorities, work independently and work well with a diverse group of people is essential.
    ● Ability to work effectively as a team member with a strong collaborative management style.
    ● Ability to think and act strategically and proactively.
    ● Proficiency in reading, writing, and communicating in English.
    ● Excellent computer skills including Microsoft Office Suite (Outlook, Word, Excel).
    ● Knowledge of medical terminology, revenue cycle processes including: health insurance verifications, billing,
    collections, cash posting functions and coding is a plus.
    ● Solid understanding of billing software and EHR/EMR. "Eyefinity Practice Management" experience is a Plus.
    ● 3-5 years of experience in payment posting, denials/rejections and AR management. Experience with "Trizetto"
    clearing house is preferred.
    ● Reliable, and willing to work “night shift” in the Philippines.
    ● Understands Credentialing workflow.