The HMO Biller is responsible for preparing, submitting, and managing insurance claims to HMOs, ensuring accurate and timely reimbursement for healthcare services.
This role involves extensive interaction with insurance companies, healthcare providers, and patients to resolve billing issues and optimize revenue cycle processes.
Key Responsibilities :
Claims Preparation and Submission :
- Prepare and submit clean claims to HMOs, ensuring all necessary documentation is included.
- Verify patient insurance coverage and eligibility before billing.
- Utilize billing software to generate claims and track submissions.
Accounts Receivable Management :
- Monitor and follow up on unpaid or denied claims, working with HMOs to resolve issues.
- Reconcile accounts and manage accounts receivable aging reports.
- Post payments and adjustments to patient accounts accurately.
Denials and Appeals :
- Review and analyze denied claims, determining the cause of denial.
- Prepare and submit appeal letters and supporting documentation to HMOs.
- Track the status of appeals and work to resolve them promptly.
Skills :
- Strong understanding of medical terminology, CPT, ICD-10, and HCPCS coding.
- Excellent organizational and time management skills.
- Detail-oriented with a high level of accuracy.
- Strong communication and interpersonal skills.
- Proficiency in Microsoft Office Suite and billing software.
Attributes :
- Ability to work independently and as part of a team.
- Problem-solving skills and the ability to handle complex billing issues.
- Commitment to maintaining patient confidentiality and compliance with HIPAA regulations.
Summary :
The HMO Biller plays a critical role in the financial health of healthcare organizations by ensuring that claims are processed accurately and efficiently.
This position requires a thorough understanding of HMO billing processes, strong attention to detail, and the ability to work collaboratively with various stakeholders to resolve billing issues.
Medical Biller/Front desk manager
Front dek manager to join our outpatient cardiology clinic in uptown manhattan! As a Medical Biller, you will be working closely with patient, staff and the doctor to answer questions related to billing, processing all forms needed for insurance billing purposes, and collecting necessary documentati...
Front desk/Biller Medical Office
Full time or Part Time Premier Allergy Medical Office in Midtown Manhattan. ...
Assistant Medical Biller
As a Medical Biller, you will be working closely with clients to answer questions related to billing, processing all forms needed for insurance billing purposes, and collecting necessary documentation from clients. You will also assist other Medical Billers with follow-up inquiries to clients, commu...
Certified Medical Biller
Our medical billing specialists are responsible for correctly coding mental healthcare claims in order to obtain reimbursement from insurance companies. They review claims data to ensure that assigned diagnosis and CPT codes meet required medical necessity prior to submission. Assign appropriate ICD...
Chinese Speaking Medical Biller
As a Medical Biller, you will be working closely with patients to answer questions related to billing, processing all forms needed for insurance billing purposes, and collecting necessary documentation from patients. Previous experience with medical coding or billing desired. ...
Medical Biller
As a Medical Billing Clerk, you will play a key role in the Revenue/Billing department. Perform data entry by transferring information from the Electronic Health Records (EHR) system to the medical billing system. Prior experience in medical billing or healthcare administration preferred. ...
Revenue Cycle Analyst (Medical Biller)
Familiarity with Medical Billing software systems such as Acunetix and Avatar for EHR. ...
Certified Medical Biller
Qualifications: Certified Medical Biller (CMB) certification is required Minimum of 2 years of experience in medical billing, preferably in mental health services Strong understanding of insurance processes, coding (CPT, ICD-10), and medical terminology Excellent attention to detail and organization...
Medical Receptionist/ Biller
Seeking an EXPERIECED Front Desk/reception/appointments/referrals, authorizatio experience necessary....
Medical Biller
The HMO Biller is responsible for preparing, submitting, and managing insurance claims to HMOs, ensuring accurate and timely reimbursement for healthcare services. Strong understanding of medical terminology, CPT, ICD-10, and HCPCS coding. The HMO Biller plays a critical role in the financial health...