What are the responsibilities and job description for the Regional Medical Biller position at Consensus Health?
Located in:
Bridgeton, New Jersey 08302
Under the general supervision of the Practice Manager/Supervisor, the Medical Biller is primarily responsible for checking eligibility and benefits, obtaining pre-authorizations, preparing and transmitting claims, posting payments, and following up on any unpaid claims or denials.
Job Title: Medical Biller
Department/Location: Operations
Reports to: Practice Manager/Supervisor
FLSA Status: Non-exempt
Direct Reports: n/a
Company Overview
Consensus Health is New Jersey’s fastest growing independent, multi-specialty medical group focused on improving the healthcare experience for patients. Providers throughout the state join like-minded peers and enjoy a wealth of benefits, including ground floor ownership and leadership opportunities, access to new payer contracts and value-based programs, a unified technology platform and a host of management services to drive outstanding practice and population health performance.
Consensus is committed to attracting, developing, and retaining talented people who are passionate about helping physicians and their staff deliver better care to patients and whose values align with ours. We empower our employees to bring the right solutions forward to strengthen the relationship between providers and patients and ensure that our staff are well served.
Position Summary
Under the general supervision of the Practice Manager/Supervisor, the Medical Biller is primarily responsible for checking eligibility and benefits, obtaining pre-authorizations, preparing and transmitting claims, posting payments, and following up on any unpaid claims or denials.
Duties and Responsibilities
The duties include, but are not limited to:
- Checking eligibility and benefits verification for treatments and procedures
- Obtaining pre-authorizations and referrals as required
- Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing
- Ensuring the timely billing of claims as to remain compliant with CMG policies and payor guidelines
- Reviewing patient bills for accuracy, completeness and obtain any missing information
- Identifying and billing secondary or tertiary insurances
- Address and correct claim issues that are assigned for practice resolution
- Update patient accounts to reflect accurate demographic and insurance information
- Answering all patient or insurance telephone inquiries pertaining to assigned accounts
- Setting up patient payment plans
- Work with MSO to accurately report accounts to the collections agency
- Performs miscellaneous job-related duties as assigned
Qualifications or Education, Training and Experience
- HS Diploma or GED required
- Minimum of 3-5 years of experience working as a medical biller, preferably in a patient practice setting
- Experience with variety of insurances
- EMR experience required, Athena preferred
Knowledge and Skills/Expected Competencies
- Knowledge of CPT & ICD-10 coding
- Must have working knowledge of medical terminology
- Ability to use independent judgment and to manage and impart confidential information.
- Ability to analyze and solve problems; requires details, data and facts that must be analyzed and challenged prior to making decisions
- Strong communication and interpersonal skills.
- Ability to clearly communicate medical information to professional practitioners and/or the general public.
- Ability to maintain confidential information
- Excellent organization, prioritization, follow up, analytical and time management skills with ability to handle multiple priorities and deadlines.
- Ability to face multiple deadlines that must be met on time.
- Ability to deal with multiple interruptions on a continual basis that must be met with a friendly exchange with others.
- Helpful and constructive view of working with others to achieve positive outcomes.
Physical/Mental Demands and Work Environment
The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to walk, bend, sit, talk, lift, or hear. The employee is regularly required to stand, walk and use hands and arms to operate general office equipment (PC, telephone, file cabinets, copier, postage meter, fax machine and printer). The employee may occasionally lift and/or move between 10 and 25 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus. The employee may need to travel to healthcare practices.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. The noise level in the work environment is usually low to moderate.
The Company reserves the right to modify the job description based upon its needs and may require the employee to perform functions beyond those mentioned above. Neither this job description nor any other communication creates an employment contract between the Company and the employee.
Equal Employment
Our culture encourages individual development, embraces an inclusive environment, rewards innovative excellence and leads New Jersey in provider and patient satisfaction. Consensus Health values diversity, inclusion, and equity as matters of fairness and effectiveness. We are committed to hiring and retaining a staff that reflects the diversity of the communities we serve, fostering an inclusive working environment where staff of all backgrounds feel welcomed and engaged.
Consensus Health is an Equal Opportunity Employer and encourages applications from individuals underrepresented in the medical sector, including people of color, and persons with non-traditional work and educational experience. All who believe they meet the stated qualifications are invited to apply.
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