Medical Biller

The Biller Representative is responsible for collections, account follow up, billing and allowance of posting for the accounts assigned to them.

Duties and Responsibilities

• Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites
• Productivity to process 60 – 70 accounts per day or as assigned the assigned task work queue
• Meets and maintains daily productivity/quality standards established in departmental policies
• Meets and maintains quality standards established in departmental policies
• Uses the workflow system, client host system and other tools available to them to collect payments and resolve accounts
• Adheres to the policies and procedures established for the client/team
• Knowledge of timely filing deadlines for each designated payer
• Initiate appeals when necessary
• Ability to identify and correct medical billing errors
• Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete recovery process
• Ability to analyze, identify and resolve issues causing payer payment delays
• Ability to analyze, identify and trend claims issues to proactively reduce denials
• Understanding of under payments and credit balance process
• Perform special projects and other duties as needed. Assists with special projects by utilizing excel spreadsheets, and the ability to communicate results
• Act cooperatively and courteously with patients, visitors, co-workers, management and clients
• Work independently from assigned work queues
• Maintain confidentiality at all times
• Maintain a professional attitude
• Other duties as assigned by the management team. Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
• Remote

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or abilities:

• High school Diploma (Required)
• CPC (Preferred)·
• 2 years’ experience in insurance collections, including submitting and following up on claims for a Medical Practice, Medical Facility/Medical Billing Company, Ambulatory Surgical Center, and/or Hospital
• Physician/Professional Billing: 1 year
• Knowledge of the denied claims and appeals process
• Knowledge of Worker’s Comp and PIP preferred
• Extensive knowledge of individual payor websites, including Navinet, Medicare, Medicaid, Availity
• Knowledge of Medical Terminology, CPT Codes, Modifiers and Diagnosis Codes
• Proficiency with MS Office. Must have basic Excel skillset
• Experience with practice management systems. EPIC PB, Allscripts and/or Cerner preferred.

AAP/EEO Statement
In order to provide equal employment and advancement opportunities to all individuals, employment decisions will be based on qualifications and job related abilities. We do not discriminate in employment opportunities or practices on the basis of race, color, religion, sex, national origin, age, disability, ancestry, sexual orientation, marital status, gender identity or any other characteristic protected by law. We will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in undue hardship.

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