Position Description

TITLE:  Medical Billing Representative

REPORTS TO: Billing Supervisor

DATE:  March 1st  2019

WAGE CLASSIFICATION: Hourly

POSITION SUMMARY: The Medical Billing Representative is responsible for all functions related to submitting electronic and paper claims to Medicare, Medicaid and Commercial payers accurately and on time. The Medical Billing Representative is also responsible for research, patient account resolution and is a resource and contact for Insurance, client and payer concerns. Coordinates and works closely with the facilities to obtain required information for monthly billing.

DUTIES INCLUDE:

  • Manage Claims process from submittal to reimbursement.
  • Import HL7 files of monthly billing charges and lab results into the billing system.
  • Verify accuracy of monthly charges in billing system.
  • Reconcile total treatments with the reports from the clinical system.
  • Prepare claims in accordance with the payers’ requirements ensuring compliance with payer rules and regulations.
  • Timely submission and follow-up of electronic and paper claims.
  • Resolve claims rejections and responds to insurance correspondence.
  • Review denials, make appropriate corrections and re-bill claims.
  • Follow standard procedures and account documentation guidelines.
  • Reviews underpayments, researches and acts to reach account resolution.
  • Print and mail claims along with Medicare EOB to Secondary payer when necessary.
  • Update insurance information in the billing system as necessary.
  • Assist with special projects as assigned.
  • Maintain a professional work relationship with all facility and office staff.

MINIMUM QUALIFICATIONS & SKILSS REQUIED:

  • High school diploma or equivalent.
  • Previous healthcare revenue cycle experience required.
  • Must have knowledge of HMO, PPO, Medicare and Medicaid billing guidelines.
  • Knowledge of ICD-10, CPT and HCPCS codes, billing practices, medical terminology, code sets and cliam forms preferred.
  • Effective verbal and written communication and positive interpersonal skills.
  • Excellent organizational skills with the ability to prioritize and handle multiple tasks.
  • Attention to detail, critical thinking, problem solving, investigative, and decision-making skills required.
  • Ability to use tact and diplomacy with patients and internal customers in all situations.
  • Working knowledge of Microsoft Outlook, Word and Excel.
  • Maintain knowledge and ability to perform company business within the United States of America, and at international locations designated by the Company.

PHYSICAL DEMANDS:

While performing the duties of this job, the employee is regularly required to sit for up to eight hours. Manual dexterity which allows the individual to use hands to type on a keyboard, use a mouse and write are required, as is the ability to talk and hear. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

BACKGROUND CHECKS:

Visonex handles confidential patient financial and medical information.  This position requires the employee to handle confidential patient financial and medical information and confidential company information.  This position also requires the employee to work closely with other employees in a supervisory capacity, to have direct responsibility for use of substantial company resources, and to make decisions of major significance for the company.  Visonex requires employees in this position to satisfactorily complete  these pre-employment screens.

CONCLUSION:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  The duties listed above are intended only as illustrations of the various types of work that may be performed.  The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to the position.  The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

 

Visonex, LLC is an Equal Opportunity Employer.  In compliance with state and federal law, Visonex will provide reasonable accommodations to qualified individuals with disabilities and encourages both prospective employees and incumbents to discuss potential accommodations with the employer.  The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Send your resume to Visonex Human Resources. If you have any questions contact Visonex at (920) 496-0600 or toll free at (866) 847-6639 to talk to a Human Resources representative.