Certified Medical Biller I Claims Specialist

Maintain and organize client records, ensuring compliance with confidentiality and data protection regulations such as HIPAA. Manage appointments for therapists and psychiatrists, ensuring efficient use of time and resources. Serve as a liaison between clients, therapists, and other stakeholders, handling inquiries and providing timely information. Prepare reports, letters, and other documentation required for internal and external use, including insurance and billing purposes.

Review denials on EOB statements and resolve issues to completion. Investigate denials and rejections via insurance portals and communication channels. Analyze Accounts Receivable (AR) reports to follow up on unpaid claims. Post payments accurately to patient accounts and reconcile discrepancies to maintain accurate financial records. Send appeals for denied claims, including necessary documentation. Correct and resubmit unprocessed or returned claims to insurance providers. Ensure timely billing by researching claims for required information. Regularly communicate with insurance companies, adjusters, and patients. Execute appropriate collection activities in compliance with practice guidelines. Perform additional duties to support billing operations and team efficiency.

Coordinate and manage patient appointments, ensuring accurate documentation and timely follow-ups. Verify insurance eligibility and benefits, resolving discrepancies to prevent billing issues. Maintain and update patient records in compliance with HIPAA regulations using EHR/EMR systems. Prepare and submit insurance claims, follow up on unpaid claims, and address patient billing inquiries. Handle appointment reminders, follow-up calls, and general inquiries to ensure patient satisfaction and engagement.