Job Title: Work-at-Home Medical Biller
Job Summary:
A work-at-home medical biller plays a crucial role in the healthcare industry by ensuring accurate and timely billing for medical services provided to patients. This remote position involves reviewing medical records, coding procedures and diagnoses, and submitting claims to insurance companies or patients. The primary goal is to maximize revenue for healthcare facilities while adhering to industry regulations and ethical standards.
Key Responsibilities:
- Medical Coding: Accurately assign CPT (Current Procedural Terminology) and ICD (International Classification of Diseases) codes to medical procedures, diagnoses, and services based on provided documentation.
- Claim Preparation: Prepare and review insurance claims for accuracy and completeness, ensuring that all required information is included.
- Billing: Submit claims to insurance companies, government healthcare programs, or patients using electronic billing systems or paper forms as needed.
- Follow-Up: Monitor the status of claims and follow up on unpaid or denied claims. Resolve any billing discrepancies or issues promptly.
- Patient Communication: Communicate with patients regarding their bills, insurance coverage, and payment options. Provide assistance and answer questions regarding billing matters.
- Compliance: Stay up-to-date with healthcare regulations and insurance policies to ensure compliance in the billing process.
- Documentation: Maintain organized and accurate records of all billing and coding activities. Ensure confidentiality of patient information in accordance with HIPAA regulations.
- Revenue Optimization: Identify opportunities to maximize revenue by correctly coding services and pursuing outstanding claims.
- Problem Solving: Investigate and resolve billing-related issues, such as claim denials, rejected claims, and billing discrepancies.
- Software Proficiency: Utilize medical billing software and electronic health record (EHR) systems to input and retrieve patient information, codes, and billing data.
- Quality Assurance: Perform regular quality checks to ensure billing accuracy and compliance with industry standards.
- Reporting: Generate reports on billing activities, including claim status, reimbursement rates, and outstanding balances.
- Education and Training: Stay informed about updates and changes in medical coding and billing procedures through ongoing education and training programs.
Qualifications:
- High school diploma or equivalent; an associate's or bachelor's degree in healthcare administration or a related field is a plus.
- Certification in medical billing and coding (e.g., Certified Professional Coder (CPC)) is highly desirable.
- Previous experience in medical billing and coding, preferably in a remote or work-from-home setting.
- Proficiency in medical coding systems, such as CPT, ICD-10, and HCPCS.
- Familiarity with insurance claim submission processes, including knowledge of various insurance plans and policies.
- Strong attention to detail and analytical skills.
- Excellent communication and interpersonal skills for patient and insurance company interactions.
- Knowledge of medical terminology and healthcare procedures.
- Proficiency in using medical billing software and EHR systems.
- Ability to work independently, meet deadlines, and manage time effectively.
- Adherence to strict confidentiality and HIPAA regulations.
Working from home as a medical biller requires self-discipline, a reliable internet connection, and the ability to work independently while maintaining high levels of accuracy and productivity.