Medical Billing Analyst

MISSION STATEMENT

Confirm and coordinate health insurance benefits to optimize health and automobile insurance payments for treatment related to the injuries arising from their legal claims.

Use this understanding to maximize the recovery for our clients.

Verify balances due to providers ensuring disbursement is accurate.

Assist Case Managers and Paralegals to achieve desired results on behalf of the client.

RESULTS/OUTCOMES (What you must get done).

  • Submit Med Pay and Health Ins information to all treating providers within 30 days of being retained.
  • Submit Med Pay and Health Ins information to all treating providers when providers are updated by Case Manager, within 15 days of new provider information.
  • Verify all outstanding medical balances within 7 days when a case moves into negotiations.
  • Verify any outstanding medical balances within 5 days of a case being settled.
  • Obtain final health insurance and med pay ledgers within 3 days of a case being settled.
  • Ensure overdue tasks never exceed 60

DUTIES/RESPONSIBILITIES

  • Following up with all providers after providing med pay and health insurance info to ensure bills are being properly submitted to the proper carrier.
  • Maintain accurate record of all bills, payments, adjustments, and the remaining balances due to facilitate negotiating discounts by disbursement staff, paralegals and attorneys; thus maximizing recovery for our client.
  • Complete all checklist items in a timely fashion.
  • Coordinate benefits with available insurance including but not limited to Med Pay, Health Insurance, Medicaid, Medicare, Veterans Benefits and other Federal and State programs.
  • Open claims and submit necessary documents for Medicare and Medicaid benefits.
  • Dispute unrelated claims.
  • Maintain the client’s Medicare portal.
  • Attend Tuesday and Friday firm Huddles at 8:00 am
  • Attend Monday, Wednesday and Thursday mini huddles with your Team Lead
  • Attending weekly OOS meetings fully prepared with strategy notes in SmartAdvocate in accordance with the preparation guideline.
  • Attend and participate in weekly firm training, when possible
  • Monitor dashboard Metrics/KPIs and successfully work toward keeping those metrics in top shape.
  • Follow and maintain all firm policies and procedures.

COMPETENCIES:

  • Excellent communication skills, verbal and written.
  • Strong advocacy for client and against pushy insurance representatives or medical providers.
  • Confidence and motivation to exceed expectations.
  • Professional attire and demeanor.
  • Desire to learn, develop, and motivate team members.
  • Team player.
  • Ability to change in a rapidly changing environment.

BENEFITS

  • A positive fun, caring environment where learning and growing are encouraged
  • Opportunities for community outreach throughout the year
  • Medical/Dental/Vision Benefits, 401k, PTO, Bonus Pay