Description
As a Patient Support Medical Billing Representative, you'll be part of a team that delivers meaningful assistance to patients through co-pay cards, vouchers, and claims support.
Your primary responsibility will be to receive medical claims from healthcare providers (HCPs) or patients, review supporting documentation, and vet each claim against program-specific business rules to determine whether it should be paid or rejected.
Job Responsibilities
- Receive medical claims from healthcare providers (HCPs) or patients and ensure all required supporting documentation is provided.
- Interpret Explanation of Benefits (EOB) and CMS-1500 forms.
- Evaluate claims against program-specific business rules to determine approval or rejection.
- Maintain exceptional organisational skills to manage daily workload.
- Provide support to customer inquiries via phone, email, fax, or other communication channels.
- Identify operational challenges and recommend solutions to management as needed.
- Adhere to HIPAA guidelines.
- Prioritise tasks effectively throughout the day.
- Meet daily productivity and quota expectations.
- Work 40 hours per week under moderate supervision.
Minimum Education & Experience
- High School Diploma or equivalent Required
- Completion of Medical Billing Program or Medical Billing degree or Certified Medical Billing license Required
- Experience in claim processing Required
- Ability to interpret EOBs Required
- Insurance verification experience Required
- Experience with payment postings Required
- Call centre, customer service experience (inbound/outbound calls) Required
- Revenue cycle experience Preferred
- Proficiency in Microsoft Office (Excel, Word, Outlook, Teams) Preferred
- Experience with secondary and tertiary billing Preferred
- Familiarity with complex insurance scenarios Preferred
- Experience with multi-layered billing processes Preferred
The pay range for this role is $23.00 per hour.