Description:
The Medical Billing Auditor is responsible for ensuring that there are no errors in medical bills or any fraudulent activity and claims are submitted in a timely manner.
Responsibilities
- Prepare, manage, and audit all primary and secondary insurance verifications and re-verifications for medical insurances such as Medicare, Private and Managed Care patients via paper or electronic means according to payer specific rules.
- Responsible for pre-billing audits, inputting and maintaining the daily client lists and pre-billing audits in the Accounts Receivable (AR) or other financial software systems.
- Accurately maintain all patient accounts including monthly statements and collections.
- Research and resolve EOB rejections and other issues with outstanding accounts.
- Post cash receipts and adjustments as needed.
- Facilitate initial and ongoing authorizations from patient insurances.
- Review contracts to verify insurance payment and insurance requirements.
- Assist facilitating and managing the Monthly Triple Check process.
- Assist in maintaining payer setup in the AR software.
- Communicate with managers and staff as required to obtain or verify billing information.
- Communicate with patients and/or families regarding patient data and account status.
Qualifications
- Minimum two (2) years’ experience in Healthcare Billing and Collections to include Medicare Part A & Part B, Commercial, Medicaid and co-insurance are required.
- Proficient computer skills with familiarity with computer applications to include medical billing software systems and Microsoft Office (Word, Excel, Outlook, and PowerPoint).
- Home Health billing experience is required.
- Experience with Way Star and Well Sky software is preferred.