Medical Biller/Claims Processing - Patient Support Representative (Home-Based)
Core
Process medical claims and payment assistance solutions (co-pay cards, vouchers) for patients and healthcare providers by reviewing documentation and applying business rules.
Role type
Medical Biller / Claims Processor
Builds
Payment assistance programs and claims adjudication workflows
Domain
Healthcare / Medical Billing
Required skills
Medical claim processing, EOB interpretation, CMS-1500 form interpretation, Insurance verification, Payment posting, HIPAA compliance, Customer service (inbound/outbound)
Preferred skills
Revenue cycle management, Secondary/tertiary billing, Multi-layered billing processes, Microsoft Office proficiency
Technologies
Microsoft Office (Excel, Word, Outlook, Teams), CMS-1500 forms
Responsibilities
Receive and review medical claims from HCPs or patients, Evaluate claims against program-specific business rules to determine approval or rejection, Provide support to customer inquiries via phone, email, or fax, Maintain organizational skills to manage daily workload, Identify operational challenges and recommend solutions, Adhere to HIPAA guidelines
Seniority
Entry-level to Mid-level, Individual Contributor