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Job Description

SUMMARY: The Medical Biller and Collections Coordinator plays a crucial role by ensuring providers are properly reimbursed for the services they provide to patients. Responsible for accurately and efficiently processing healthcare claims, coding medical procedures, accurately inputting information into the billing system, and submitting claims to insurance companies.

DUTIES AND RESPONSIBILITIES:

• Generate and electronically submit claims and statements at designated intervals ensuring they are processed in a timely manner; corrects any errors for complete and accurate transmission of data.
• Monitor the status of submitted claims, follow up with insurance companies to resolve any discrepancies or denials, and resubmit claims as needed.
• Record payments received from insurance companies, patients, or other sources and apply them to the appropriate accounts while maintaining balance sheets.
• Assign appropriate medical codes (e.g., ICD-10, CPT) to diagnoses, treatments, procedures, and surgeries using established coding systems.
• Prepare and review medical claims for accuracy, completeness, and compliance with insurance and government regulations.
• Generate bills and invoices for patients and insurance companies based on the services provided.
• Answer patient inquiries regarding billing and insurance, explain charges, and provide assistance in resolving billing disputes.
• Stay up-to-date with changes in healthcare regulations, insurance policies, and coding guidelines to ensure compliance with legal requirements.
• Maintain accurate and organized records of all billing and claims-related activities.
• Generate reports to track billing and collections performance, including accounts receivable aging reports.
• Researches and processes refund requests and overpayments.
• Prepares correspondence and/or collection letters.
• Prepares letters of appeal to insurance companies if the company refuses to pay contracted claims and/or denies a claim; submits documentation necessary to support claim; resubmits claims with corrections if needed for payment for all insurance payers.
• Performs additional duties including but not limited to copying checks received and recording payment, faxing information as required, generating retroactive authorization requests, and verifying medical eligibility.
• Performs other related duties as assigned by management.

QUALIFICATIONS:

• High school diploma or equivalent; prefer a degree or certification in medical billing or related field.
• MUST HAVE STRONG NJ OON ORTHOPEDICS COLLECTIONS EXPERIENCE!
• Knowledge of medical terminology, anatomy, and coding systems (ICD-10, CPT).
• Proficiency in medical billing software and electronic health record (EHR) systems.
• Strong attention to detail and accuracy.
• Excellent communication and interpersonal skills for interacting with patients, healthcare providers, paralegals, and insurance companies.
• Knowledge of healthcare billing regulations and compliance standards.
• Problem-solving skills to resolve billing discrepancies and denials.
• Proven ability to handle multiple projects and meet deadlines

BENEFITS:

• Competitive salary
• Health, dental, and vision insurance
• Retirement Plan
• Employee Assistance Program
• Paid time off
• Opportunities for professional development and growth
• Collaborative and supportive work environment

SCHEDULE: Monday to Friday (no weekends)

JOB TYPE: Full-Time (8 hour shifts)

We are an Equal Opportunity Employer. All qualified applicants will be considered for employment regardless of age, national origin, race, color, disability, religious beliefs, or sexual orientation.

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