Billing Associate

Responsibilities

• Review patient orders and supporting documentation to ensure they meet applicable insurance and payer requirements prior to claim submission
• Verify required prior authorization, pricing agreement, and other reimbursement documentation
• Identify missing, incomplete, or inconsistent information and collaborate with appropriate internal teams to obtain required documentation
• Review claims for accurate patient, provider, product, diagnosis, coding, and insurance information before submission
• Prepare and submit medical claims accurately and within established timelines
• Submit claims through electronic billing systems, payer portals, paper mail, and other required submission methods
• Resubmit corrected claims and supporting documentation when necessary
• Review patient accounts, order information, and applicable records to confirm billing eligibility
• Maintain accurate claim submission status and billing information within patient and billing systems
• Verify new payers and establish payer profiles within the billing system
• Create invoices and process payments for self-pay patients in accordance with company procedures
• Maintain accurate, complete, and organized billing records and supporting documentation
• Collaborate with internal teams to resolve patient order discrepancies and obtain missing billing or insurance information
• Partner with Finance and other internal stakeholders as needed to provide claims information and support reconciliation activities
• Assist with billing data entry, audits, reporting, and other administrative activities as needed
• Identify recurring documentation or billing issues and escalate trends or opportunities for process improvement
• Follow company policies and procedures related to billing, documentation, patient information, and confidentiality
• Protect patient privacy and handle protected health information (PHI) in accordance with HIPAA and applicable regulatory requirements
• Maintain a high level of accuracy and productivity while managing multiple claims and priorities in a fast-paced environment