Medical Billing Representative

Summary

Join Brave Health as a Medical Billing Representative and become the primary point of contact for patients' billing inquiries. This full-time, remote position requires strong customer service skills and medical billing experience. You will handle inbound/outbound calls, manage patient accounts, work with insurance companies, and ensure accurate claim processing. The ideal candidate possesses strong communication, organizational, and problem-solving skills, along with knowledge of medical billing practices and HIPAA regulations. Brave Health offers a competitive hourly rate, comprehensive benefits, and a supportive team environment.

Requirements

• Minimum one year of medical billing experience in a healthcare setting
• High school diploma or equivalent
• Strong knowledge of medical billing, Medicaid, Medicare, and commercial insurance practices
• Ability to review and prepare clean claims, work denials, appeals, and resubmit claims as necessary
• Excellent oral and written communication skills
• Ability to handle inbound/outbound calls and interact with patients, guarantors, or insurance companies in a fast-paced environment
• Experience handling escalated calls, resolving billing discrepancies, and maintaining high customer satisfaction
• Proficiency in Word, Excel, and practice management systems
• Strong documentation and data management skills, including updating patient demographics and insurance information
• Ability to reconcile batch totals and process insurance and patient refunds accurately
• Strong organizational skills with the ability to work independently and meet deadlines
• Ability to identify billing, system, or collections issues, monitor high-balance accounts, and address insurance claim problems
• Effective problem-solving, decision-making, and analytical skills
• Ability to work cohesively in a team-oriented environment while fostering good working relationships
• Knowledge of HIPAA Privacy & Security regulations and ability to handle confidential information securely

Responsibilities

• Handle inbound and outbound calls to answer inquiries from patients, guarantors, and insurance companies regarding account status, billing discrepancies, and payment arrangements
• Regularly contact patients to explain charges and assist them with understanding their insurance benefits and claims
• Update patient demographics and insurance information while documenting all interactions, including inquiries, complaints, and resolutions
• Manage escalation calls to ensure patient satisfaction and de-escalate challenging situations
• Work with medical insurance companies to resolve payment issues, review patient eligibility, and obtain necessary authorizations and referrals to ensure claims approval
• Prepare, review, and transmit claims in accordance with payer regulations to produce clean claims, process EDI rejections, and handle denials through appeals or resubmissions
• Monitor high-balance accounts and identify insurance issues or billing trends, reporting them to leadership as necessary
• Utilize online insurance and practice management systems for tasks such as eligibility checks, claim status monitoring, and payment processing
• Process insurance and patient refunds and ensure payment arrangements comply with company policies
• Collaborate with the contracting and credentialing department to complete payor enrollment and set up newly contracted payors within the billing system
• Maintain accurate records of enrollment activities, update payer fee schedules, and track progress on claims and payments
• Work correspondence, aged accounts receivable, and assist with resolving eligibility issues
• Apply sound judgment in handling confidential information, following HIPAA guidelines, and meeting organizational financial goals

Preferred Qualifications

• Bilingual in Spanish
• Experience with EDI systems, claim status monitoring, and insurance portals is an advantage
• Experience working with Florida Medicaid is a plus

Benefits

• W2, Full-time hourly position
• Monday - Friday schedule; No on-call or weekend shifts
• Health, Dental, Vision Insurance benefits
• Vacation, Holiday and Sick time