PHMC is proud to be a leader in public health. PHMC requires that all employees have received the first Covid-19 vaccination dose by the first day of employment. We will offer the Covid-19 vaccination at no cost, via our Health Centers.

Mission Statement: 

Our Mission is to be the premier regional provider of integrated, community-based healthcare by combining evidence-based clinical practices, outstanding patient service, innovative care partnerships, and team-driven excellence, within a healthy fiscal environment.

The Medical Biller is an integral part of the revenue cycle team and reports directly to the Medical Billing Supervisor. This candidate has experience in billing and coding including ICD-9, ICD-10, CPT-4, and HCPCS. Primary responsibilities include data entry, charge entry, monitoring and correcting returned vouchers, insurance-eligibility verification, following-up with health care providers on unsigned encounters, and completing pay for performance quality incentive worksheets.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Monitors and corrects returned items from billing partner to enhance revenue cycle operations. 
• Performs Insurance eligibility verifications.
• Works in conjunction with the front desk and providers to ensure clean billing.
• Initiates a dialogue with insurance carriers regarding unpaid claims.
• Researches and responds by telephone/writing to patient inquiries regarding billing issues and problems.
• Assists providers in selecting correct CPT and diagnosis codes when needed.
• Completes pay for performance quality incentive worksheets. 
• Answers questions from patients, staff and insurance companies.
• Identifies and resolve patient billing complaints.
• Participates in educational activities and attends billing staff meetings.
• Makes recommendations to remove obsolete and update current CPT codes.

PHMC Compliance Responsibilities: 

• Understands and adheres to PHMC compliance standards as they appear in the PHMC: Code of Conduct, Whistle Blowers and Conflict of Interest Policies. 
• Keeps abreast of all pertinent federal, state and PHMC regulations, laws, and policies as they presently exist and as they change or are modified. 
• Comply with HIPAA and Confidentiality Policies and Procedures as they apply to the job. 
• Comply with Department of Public Health (DPH), The Joint Commission and other accreditation and regulatory agencies standards. 
• Adhere to all PHMC Policies and Procedures. 
• Knowledge and adherence to Infection Control and Environment of Care Guidelines and Procedures as described in the annual education module.

Job Requirements: 

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below must be representative of the knowledge, skills, minimum education, training, licensure, experience, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Skills: 

• Knowledge of ICD-9, ICD-10, CPT-4, and HCPCS
• Knowledge of medical terminology
• Proficient in using practice management systems and EHRs
• Proficient with using Windows and Microsoft Office/Excel
• Possession of strong problem-solving skills and sound judgement
• Able to organize and meet deadlines
• Able to work independently

Experience: 

• 1 year of experience with billing and coding
• Certified Professional Coder (CPC) and/or Certified Professional Biller (CPB) preferred
• Experience with Allscripts EHR, PM, and Payer Path preferred

Education: 

• High School Diploma or GED required
• Graduate from Medical Billing and Coding Program

Physical Demands: 

• Position requires standing 2/3 of the time, walking 2/3 of the time. requires sitting under 1/3 of the time, use of hands to finger, handle or feel 2/3 of the time, reach with hands and arms, under 1/3 of the time, stoop, kneel, crouch or crawl under 1/3 of the time. talk or hear over 2/3 of the time. Position requires lifting up to 10 lbs. up to 1/3 of the time.