Our Oakland County client is looking for a medical biller/collector to start immediately. As the Medical Biller (Collections), you will perform collections functions for unpaid and/or delinquent patient and agency account balances, initiating appropriate action and maintaining records. Additional duties include the review status of delinquent accounts that appear on the monthly aging report and initiate collection action to resolve unpaid balances; Review decisions from insurance companies and initiate appeal of decisions if necessary; answer rejections and other written correspondence from insurance carriers, request informal or telephone hearing when claim appeals are upheld. The specialist should meet defined department goals and activity metrics, process account adjustments according to company policies as identified. Initiate or direct rebilling and follow-up on claims through payment resolution and obtain additional documentation to substantiate medical necessity and any other duties assigned.
The ideal candidate will have HDMS Billing Software; Excel Spreadsheet software and Microsoft Office Word Processing software experience. Additional requirements include knowledge of Managed Care, BC/BS, Medicare and Medicaid insurance claim submission and reimbursement and have experience with case management/utilization review. This is a temporary to full-time opportunity for the right individual.