Medical Claims Review Manager jobs in Springfield, MA

Robert Half is currently seeking a detail-oriented and experienced Medical Biller to join our growing team. As a Medical Biller you will play a crucial role in ensuring accurate and timely billing for our healthcare services. The ideal candidate will have a strong understanding of medical billing procedures, coding systems, and insurance regulations. Attention to detail, excellent communication skills, and the ability to work collaboratively with internal teams are essential for success in this role.

Responsibilities:

1. Claims Submission: Prepare and submit accurate and timely claims to insurance companies, government agencies, and other third-party payers.
2. Coding: Assign appropriate medical codes to diagnoses and procedures for billing purposes, ensuring compliance with coding guidelines.
3. Verification: Verify insurance coverage and obtain necessary authorizations for procedures and services.
4. Follow-Up: Monitor and follow up on outstanding claims, denials, and appeals to ensure timely resolution and maximum reimbursement.
5. Payment Posting: Record and reconcile payments received from patients and insurance companies.
6. Patient Inquiries: Address patient inquiries regarding billing issues, explaining charges, and providing assistance in resolving payment concerns.
7. Documentation: Maintain accurate and up-to-date documentation of billing activities and communications.
8. Compliance: Stay current on industry regulations, coding updates, and insurance policies to ensure compliance.