Associate Medical Biller/Collector CMRS

Position Overview

This role is responsible for the accurate and timely submission of medical claims to insurance providers across a variety of healthcare settings. The individual will ensure payments for medical services are received promptly and may act as a liaison between healthcare providers, patients, and insurance companies.

Key Responsibilities

• Maintain a safe and clean work environment, adhering to safety and infection control standards.


• Review patient billing information for accuracy and completeness, obtaining missing details as needed.


• Identify appropriate insurance parties to bill, including secondary and tertiary insurers.


• Utilize electronic health record (EHR) systems to perform billing tasks and maintain compliant medical records.


• Process claims and apply payments or credits accordingly.


• Verify insurance payments for accuracy and contract compliance.


• Investigate and resolve denied or partially paid claims by collaborating with involved parties.


• Manage assigned accounts to ensure timely payment of outstanding claims and follow up as necessary.


• Communicate effectively with healthcare providers, patients, and insurance representatives to clarify billing issues.


• Consult supervisors and team members to address billing and collection challenges.


• Follow established policies and procedures to maintain operational quality and elevate compliance concerns appropriately.


• Prepare reports and documentation as required.


• Perform administrative duties such as answering phones, faxing, filing confidential documents, and using email and internet tools.


• Deliver professional and courteous customer service to both internal and external stakeholders.


• Collaborate as a team member while meeting deadlines and productivity goals.

Qualifications

• Minimum of one year experience posting in a healthcare environment.


• Strong customer service skills with demonstrated leadership, teamwork, and cooperation.


• High ethical standards and professional integrity.


• Understanding of medical and surgical terminology.


• Knowledge and compliance with HIPAA regulations, maintaining strict confidentiality.


• Proficient with email, internet research, and payer websites.


• Preferred experience with billing software such as GE Centricity and SRS Caretracker.


• Excellent written, oral, and interpersonal communication skills; able to present ideas clearly and professionally.


• Highly self-motivated, detail-oriented, and able to prioritize tasks effectively in a fast-paced environment.


• Ability to interpret complex documents and respond appropriately to sensitive inquiries or complaints.

Education

• High school diploma or equivalent required.


• Associate's Degree in Business Administration preferred.

Certifications

• Certified Medical Reimbursement Specialist (CMRS) certification preferred.

All candidates must successfully complete a physical evaluation, drug screening, and background checks prior to employment. This position is based in a regional healthcare setting within the Pacific Southwest region of the United States.