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Role Description

This role involves assisting in the revenue cycle functions within the billing department as a Medical Biller. Responsibilities include:

• Submitting medical claims to insurance companies and payers such as Medicare and Medicaid
• Working directly with insurance companies, healthcare providers, and patients to get claims processed and paid
• Reviewing and appealing unpaid and denied claims
• Processing patient and insurance refund requests in a timely manner
• Posting payments and/or denials from insurance remits
• Assisting patients in obtaining correct information for charity/Medicaid applications or payment plans
• Using coded data to produce and submit claims to insurance companies
• Maintaining knowledge of current billing rules and trends by attending seminars, workshops, and webinars
• Assisting patients in verifying benefit information
• Assisting in patient scheduling and account creation
• Ensuring weekly, monthly, and quarterly department goals are met
• Utilizing eCW and multiple payer portals
• Obtaining referrals and pre-authorizations as required for procedures
• Checking eligibility and benefits verification for treatments, hospitalizations, and procedures
• Reviewing patient bills for accuracy and completeness
• Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing
• Following up on unpaid claims within standard billing cycle timeframe
• Checking each insurance payment for accuracy and compliance with contract discounts
• Calling insurance companies regarding any discrepancies in payments if necessary
• Identifying any billing secondary or tertiary insurances
• Setting up patient payment plans and working collection accounts
• Updating billing software with rate changes
• Updating cash spreadsheets and running collection reports
• Complying with all elements within HIPAA and the Privacy Act

Qualifications

• Professional with strong interpersonal skills
• Effective communication skills, both verbal and written
• Good work habits and attendance
• Ability to work independently
• Strong problem-solving skills

Requirements

• A minimum of one-year experience with medical billing
• High School Diploma or GED
• Proficiency with Microsoft Office Suite and Internet
• A knowledge of chemical dependency and its effects on individuals, families, and communities is preferred

Benefits

• Medical, vision, and dental insurance
• Short-term and long-term disability options
• Life insurance
• Employee Assistance and Life Assistance programs
• A 401K retirement program
• Pet Insurance
• Paid time off and paid holidays

Salary Description

$17.00-$18.00 per hour, DOE