Medical Biller

Medicaid Billing Representative’s role is to bill all Medicaid claims accurately and to perform collection and follow up activities related to claim payment for the Billing Department. Responsibilities include performing simple arithmetic computations, and checking EMT/driver LogistiCare forms (electronic and paper) for completeness and accuracy. Work is performed according to established procedures, and is reviewed or monitored frequently until familiarization with billing procedures is achieved.

Essential Duties and Responsibilities:

• Review all driver logs/EMT Modivcare forms for all appropriate signatures before bills are sent;
• Review documentation to ensure all information has populated in the prescribed format;
• Manually enter charges, driver and vehicle information in the Modivcare portal;
• Search for patient demographics & insurance
• Contact insurance companies & patients for eligibility & information verification
• Run collection reports/workflows for all unpaid Medicaid claims
• Follow up with Medicaid Providers on all Medicaid denials
• Prepares credits or refunds when required and forward to Billing Manager
• Submit all bills timely and accurately;
• Verify all Medicare and Medicaid information;
• Maintain Medicare and Medicaid records are accurately filed
• Maintain required documentation is received before bills are sent;
• Determine if any additional documentation is required before bills are sent
• Demonstrates continuous effort to improve operations, decrease turnaround times, streamline work processes, and work cooperatively and jointly to provide quality seamless customer service.

AA/EEO Employer

• High School education. College education and/or equivalent work experience preferred;
• Understand RescueNet (RN), Navinet, Zirmed, EMS Charts and various insurance websites, preferred;
• Knowledge of Medicare rules and regulations;
• Electronic claim submissions and remittance procedures;
• Commercial insurance claim requirements;
• Health Insurance Portability and Accountability Act (HIPAA) requirements and record retention compliance
• Excellent written and verbal communications skills required;
• Excellent documentation skills (promptness, accuracy, thoroughness, and legibility)
• Must be highly-organized;
• Excellent (or established) inter-personal skills;
• Knowledge and expertise with Microsoft Products preferred, specifically Excel and Word
• Working knowledge of EMS systems/private ambulance and medical transportation systems preferred;
• Computer proficiency preferred;