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AI Summary

The Medical Biller manages the end-to-end claims process, including verifying documentation, processing statements, and resolving carrier denials. They also maintain customer demographics, handle accounts receivable aging reports, and ensure accurate revenue cycle operations.

  • Performs the review and confirmation of work orders prior to billing, by verifying accuracy of order and required documentation such as prescriptions, certificates of medical necessity, prior authorizations, diagnosis and procedure codes.  

  • Monitors the confirmation work queue to ensure timely confirmation of work orders.  

  • Track incomplete information and communicate feedback to management and intake staff. 

    • Works accounts receivable aging reports performing follow up in accordance with policies and procedures.  

    • Generates and processes statements and claim forms in an accurate and timely manner. 

    • Obtains, verifies and maintains customer demographics and insurance information for billing purposes.  

    • Works to resolve carrier denials and correspondence for proper payment of claims.  

    • Shares responsibility through timely communication of identified problems to assure proper follow up is completed to expedite clams and ensure proper payment.  

    • Identifies potential discrepancies in claims payment processing. 

    • Answers questions and resolves problems related to billing operations. 

    • Provides clear documentation of all communication related to accounts in account or claim notes.

    • Reviews credit balance accounts on a monthly basis.  

    • Prepares appropriate paperwork when refunds are warranted, based on history of account and contractual agreements; forward to Lead Billing Account Specialist for approval and processing.

    • Assists clients with questions, payments and account resolution. 

    • Makes payment arrangements and process statements and take collection measures when necessary.

    • Billing Administration 

      • Works accounts receivable aging reports performing follow up in accordance with policies and procedures.   

      • Generates and processes statements and claim forms in an accurate and timely manner.  

      • Obtains, verifies and maintains customer demographics and insurance information for billing purposes.   

      • Works to resolve carrier denials and correspondence for proper payment of claims.   

      • Shares responsibility through timely communication of identified problems to assure proper follow up is completed to expedite clams and ensure proper payment.   

      • Identifies potential discrepancies in claims payment processing.  

      • Answers questions and resolves problems related to billing operations.  

      • Provides clear documentation of all communication related to accounts in account or claim notes. 

      • Reviews credit balance accounts on a monthly basis.   

      • Prepares appropriate paperwork when refunds are warranted, based on history of account and contractual agreements; forward to Lead Billing Account Specialist for approval and processing. 

      • Assists clients with questions, payments and account resolution.  

      • Makes payment arrangements and process statements and take collection measures when necessary.   

      • Maintains current knowledge of carrier specific requirements by attending workshops, reading newsletters and acting as liaison in carrier meetings.   

      • Provides communication and teaching to Billing Account Specialists, Payment Posting Specialist and Billing Records Technician. 

Qualifications

High School or Vocational School graduate 

 

All staff are expected to participate in appropriate continuing education as may be requested and/or required by their immediate manager.  In addition, staff are expected to accept personal responsibility for other educational activities to enhance job-related skills and abilities.  All staff must attend mandatory educational programs.

Proficient in Microsoft office software.

 

Previous medical office experience.

 

Familiar with billing codes i.e., HCPCS, Revenue, CPT Coding, Diagnosis Coding, etc.

 

HME AND BRIGHTREE EXPERIENCE REQUIRED

 

Experience with Epic is Required

 


Founded in 2003, Omega Healthcare Management Services® (Omega Healthcare) empowers healthcare to thrive via intelligent solutions that optimize revenue cycle operations, administrative workflows, care coordination, and clinical research on a global scale. The company works with providers, payers, life science companies, medical device manufacturers, health technology firms, researchers, and industry partners to amplify teams with robust technology, specialty expertise, and operational support. Omega Healthcare serves more than 350 healthcare organizations with 35,000 skilled workers in the United States, India, Colombia, and the Philippines. For more information, visit www.omegahms.com


We offer a comprehensive benefits package that may include health, dental, and vision coverage, voluntary insurance options, a 401(k) plan with employer match, professional development opportunities, paid time off, and holiday pay. Eligible employees may also have the opportunity to participate in bonus programs, commissions, or other variable incentive plans. Benefits and incentive eligibility may vary based on position, location, and tenure.

AAP/EEO Statement

Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcare also prohibits harassment of applicants or employees based on any of these protected categories.

Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources at employeerelationsus@omegahms.com.

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