PreludeDx

Collections And Medical Billing Specialist This position will perform collections and medical billing for various regional and national payers, including federal, state, third party (hmo, ppo, ipa, tpa indemnity) and patient billing. Qualified candidates must be able to (1) review accounts for billing accuracy in order to maximize reimbursement. (2) persuasive and tenacious follow-up on claims status (3) appeal, and re-bill or forward claims for recalculation and / or adjudication as necessary. Must possess detailed knowledge of all medical benefit levels and have a thorough understanding of federal, state, ppo, hmo, and indemnity plans structure. Must meet or exceed the standard level of performance on assigned accounts. essential responsibilities: data entry, correct insurance assignment to patient accounts, insurance eligibility verification. Review/update demographics and patient information for accuracy. working knowledge of appropriate coding systems; cpt, icd-9 and...

Job Summary This position will perform collections and medical billing for various regional and national payers, including Federal, State, Third Party (HMO, PPO, IPA, TPA Indemnity) and patient billing. Qualified candidates must review accounts for billing accuracy to maximize reimbursement, pursue tenacious follow‑up on claim status, appeal, re‑bill or forward claims for recalculation, and possess detailed knowledge of all medical benefit levels and federal, state, PPO, HMO and indemnity plan structures. Candidates must meet or exceed performance standards on assigned accounts. Essential Responsibilities Data entry and correct insurance assignment to patient accounts, verify insurance eligibility, and review/update demographics and patient information for accuracy. Apply appropriate coding systems (CPT, ICD‑9, HCPCS, coverage, LCD/NCD) and understand reimbursement associated with such codes. Process, validate payer requests and processed claims via correspondence, remittance...