Medical Billing Services jobs

Post

A medical biller is responsible for submitting & resubmitting medical claims to insurance companies and payers on behalf of the hospital. The main purpose of the role is to adjudicate and process the account/claim with quality in a professional manner according to policy terms and conditions. The medical biller will hold responsibility for the account/claim until payment is done. He/ She needs to apply the clinical guideline and sound judgment of medical necessity when assessing the account. Additionally, the role will need to interpret and process claims with correct usage of standard codes (e.g. ICD, DRG, CPT, and HCPCS) applicable billing structure, policy terms, and benefits. Ensure that all medical information is kept confidential as per compliance.

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Roles and Responsibilities

Reviewing patient bills for accuracy and completeness, and obtaining any missing information

Evaluates and processes claims per insurance policy terms and conditions

Work following company policies and procedures

Identify and report back any type of claims observation or issues that may affect the process

Evaluates and ensures that all claims denied or underpaid inappropriately by Payers are identified, appealed and reversed

Reviewing claims to make sure that billing requirements are met, updates accounts as necessary, answers inquiries and makes recommendations for resolution

Ensures that targets are met for department Turnaround time, Quality and Productivity

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Education, Experience, and skills needed

Education: Degree in any related field preferably life science background.

Minimum 1-2 years’ recent experience in Revenue Cycle Management - Eligibility and Authorization, Claim Submission & Resubmission. Both inpatient and outpatient experience preferred.

Expert knowledge of medical conditions, treatments, procedures and standard codes

Willingness to work in different shifts

Willingness to work from a different facility

Analytical skills to review the account before submission to the payer and ensure all required data elements are correct as per the insurance and medical code sets

Basic understanding of the billing and payer adjudication guidelines related to DHA

Basic knowledge of medical terminology

Proficiency in the use of PCs and MS Office suite

Excellent in communication skills

Understanding of the various RCM departments

Fluent Arabic speaking skills

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