Medical Claims Processor
16 days ago
Paramus
Job Description ob Title: Claims Coordinator (Medical Biller) Work hours: 9a-5pm Hybrid - 2x a week in office GENERAL FUNCTION The Medical Claims Biller is responsible for monitoring insurance carrier adjudication of Team Vision medical claims for one or more doctor practices. Utilize a practice EHR system and clearing house to review and submit claims to multiple medical insurance carriers Review open/unpaid claim balances and take required action. MAJOR DUTIES & RESPONSIBILITIES • Review medical claims and transmit to the insurance carrier using the practice electronic health records (EHR) system and clearing house., • Monitor rejected claim reports and adjust claims for resubmission to the insurance carrier., • Download insurance carrier explanation of payments (EOPs) to post claim payments and denials in the EHR system., • Determine if denied claims can be corrected and re-submitted to the carrier., • Review aging reports to research open balances and resubmit within insurance carrier filing limits., • Utilize insurance carrier websites and contact carriers as needed to investigate denials and claim status., • Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system., • Initiate overpayment refunds to patients and repayments to insurance carriers when required., • Serve as the point of contact for the practice regarding all vision and medical claims., • High school diploma, • 3+ years of related work experience, • Experience with medical billing and coding, • Ability to prioritize handling of issues, • Organization skills and ability to multitask, • Experience working in multiple doctor practices, • Experience working with multiple insurance carriers and an understanding of their claim requirements, • Proven ability to identify issues and solve problems Company DescriptionAbout company - Since its founded in 1996, CTC has grown into a trusted global partner in AI & ML, Enterprise Applications, Digital Services, Managed Services, and Business Services. With headquarters in Detroit, Michigan, CTC has a team of over 2,000 experts worldwide. We empower more than 100 organizations to tackle complex challenges and transform them into sustainable competitive strengths--driving innovation, efficiency, and growth every step of the way. Our strengths have always been Commitment to Customer, Commitment to Colleagues, and Commitment to Community (CTC).About company - Since its founded in 1996, CTC has grown into a trusted global partner in AI & ML, Enterprise Applications, Digital Services, Managed Services, and Business Services. With headquarters in Detroit, Michigan, CTC has a team of over 2,000 experts worldwide. We empower more than 100 organizations to tackle complex challenges and transform them into sustainable competitive strengths--driving innovation, efficiency, and growth every step of the way. Our strengths have always been Commitment to Customer, Commitment to Colleagues, and Commitment to Community (CTC).