What are the responsibilities and job description for the Medical Biller position at Elevate ENT Partners?

Job Description

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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