Medical Billing Accounts Receivable Specialist

Medical Claims Solutions is a team of more than 20 medical billing and credentialing professionals offering services to practices throughout the United States. We have been servicing clients since 1995. Our team helps providers focus on patient care and satisfaction by eliminating or drastically reducing complications from medical billing, credentialing and practice management.
The Medical Billing Customer Support Representative is a full-time position, responsible for interacting with internal and external customers of the company to provide information and administrative support. Duties include customer service, billing patients, compiling information, reports, and correspondence.

Critical Tasks & Responsibilities
• Follows up with insurance companies on unpaid or rejected claims. Resolves issues and re-submits claims.
• Prepares appeal letters to insurance carrier when not in agreement with claim denial. Collect necessary information to
accompany appeal.
• Create insurance or patient aging reports using the medical practice billing software. These reports are used to identify
unpaid insurance claims or patient accounts.
• Contact clients, insured or other involved persons to obtain missing information.
• Organize and work with detailed records, using computers to enter, access, search or retrieve data.
• Resolve discrepancies in accounting records.
• Consult sources, such as manuals or insurance company representatives, to determine specific changes or information
such as rules, regulations, or government tax and tariff information.

Other Duties
• Posts insurance and patient payments using medical claim billing software at times.
• Provide customer service, such as limited instructions on proceeding with claims.
• Verify accuracy of billing data and revise any errors.
• Answer mail or telephone inquiries.
• Contact customers to obtain or relay account information.
• Keep records of invoices and support documents.
• Update manuals when rules, or regulations are amended.
• Adhering to company policies, processes and procedures.
• Answer patient questions on patient responsible portions, copays, deductibles, adjustments, etc.
• Resolves patient complaints or explains why certain services are not covered.
• Follows HIPAA guidelines in handling patient information.
• Understands managed care authorizations and limits to coverage such as the number of visits. This is encountered often
when billing for specialties.
• May work with patients to establish payment plan for past due accounts in accordance with provider policies.
• May perform “soft” collections for patient past due accounts. This may include contacting and notifying patients
via phone or mail.
• For patients with coverage by more than one insurer, prepares and submits secondary claims upon processing
by primary insurer.
• Prepares patient statements for charges not covered by insurance.

Required Competencies and Qualifications (technical, academic, experience, values, behaviors)
o Developing specific goals and plans to prioritize, organize, and accomplish your work.
o Managing one’s own time.
o Talking to others to convey information effectively.
o Monitoring/Assessing performance of yourself to make improvements or take corrective action.
o Actively listening, asking probing questions of staff and customers and vendors.
o Actively looking for ways to help people.
o Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to
problems.
o Providing information to supervisors, co-workers, and subordinates by telephone, in written form, e-mail, or in person.
o Clearly demonstrated knowledge of administrative and clerical procedures and systems such as word processing,
managing files and records, and other office procedures and terminology.
o Using computers and computer systems (including hardware and software) to enter data and/or process information.
o Keeping up-to-date technically and applying new knowledge to your job.
o Performing day-to-day administrative tasks such as maintaining information files and processing paperwork.

Desired Competencies and Qualifications
o Identifying problems and reviewing related information to develop and evaluate options and implement solutions.
o Actively identifying problems and reviewing related information to develop and evaluate options and implement solutions.
o Communicating with people outside the organization. This information can be exchanged in person, in writing, or by
telephone or e-mail.
o Encouraging and building mutual trust, respect, and cooperation among team members.
o Work together to accomplish tasks.

Skills and Experience
o To perform successfully in this role, it is necessary to possess attention to detail
o Effectively manage time and complete tasks accurately is required
o Working knowledge of Microsoft office tools required
o Working knowledge of medical accounts receivable software programs preferred Kareo, Healthfusion, Office Practicum, WebPT
o Excellent communication and interpersonal skills
o Demonstrated ability to use initiative and independent judgment
o High school diploma or equivalent required
o Five years experience in medical billing required
o The ability to effectively manage time and complete tasks accurately is required.

Medical Claims Solutions is proud to be an equal opportunity workplace. We are committed to equal employment opportunities regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status.