Synlink Recruitment Outsourcing Co. Inc. Medical Biller (CSR)

Synlink Recruitment Outsourcing Co. Inc.

R$2.7-3K[Mensual]

No - Taguig1-3 Anos ExpEnsino Médio Alto/SeniorTempo Inteiro

Claim Submission & Processing* Prepare, review, and accurately submit complex medical claims (CMS-1500, UB-04) to various government and commercial payers (e.g., Medicare, Medicaid, HMOs).* Verify patient eligibility, benefits, and pre-authorization/referral requirements before claim submission to minimize denials.* Ensure all claims are supported by correct CPT, ICD-10-CM, and HCPCS codes, often collaborating with Medical Coders.
Accounts Receivable (AR) & Collections* Manage and follow up on outstanding accounts receivable (AR), actively pursuing timely payment from insurance companies and patients.* Review and interpret Explanation of Benefits (EOBs) and Remittance Advice (RAs) to accurately post payments, adjustments, and denials to patient accounts.
Denial Management & Appeals* Investigate and resolve denied, rejected, or partially paid claims by identifying root causes (e.g., coding errors, lack of medical necessity, missing documentation).* Draft and submit professional appeals and corrected claims to payers within statutory deadlines.
Compliance & Communication* Respond to billing inquiries from patients, providers, and insurance companies via phone and email, clearly explaining complex billing and financial concepts.*
Maintain strict compliance with all HIPAA regulations and payer-specific guidelines to protect Protected Health Information (PHI).* Assist patients in setting up or managing payment plans for outstanding balances.