TPA Billing Executive

Job Description

Job Description: We are seeking a detail-oriented and experienced TPA Billing Specialist to join our team. The ideal candidate will have a strong background in medical billing, particularly in handling billing processes for patients covered by third-party insurance administrators. The role involves verifying insurance coverage, preparing and submitting claims, and ensuring timely and accurate billing and collections. The TPA Billing Specialist will also be responsible for resolving billing discrepancies, communicating with insurance companies, and providing exceptional customer service to patients and insurance providers. Responsibilities: Verify insurance coverage and eligibility for patients covered by third-party administrators Prepare and submit insurance claims accurately and timely Follow up on unpaid claims and denials, and appeal as necessary Resolve billing discrepancies and answer patient inquiries regarding billing Maintain up-to-date knowledge of insurance regulations and billing guidelines Communicate with insurance companies, patients, and third-party administrators to ensure proper billing and collections Provide exceptional customer service to patients and insurance providers Assist in training and mentoring other billing staff as needed Qualifications: High school diploma or equivalent required; Associate's or Bachelor's degree preferred Minimum of 2 years of experience in medical billing, specifically with third-party administrators Proficient in billing software and electronic medical records (EMR) systems Knowledge of medical terminology, ICD-10, and CPT coding Strong attention to detail and accuracy Excellent communication and customer service skills Ability to work independently and as part of a team Certified Professional Coder (CPC) certification a plus Job Type: Full-time Benefits: Provident Fund Schedule: Rotational shift Supplemental Pay: Yearly bonus Experience: total work: 3 years (Required) Billing: 2 years (Required) Work Location: In person