Biller - FT

POSITION SUMMARY:

Bills insurance companies for all hospital and hospital based physician bills. Pursues collection of all claims until payment is made. Performs other work associated with the billing process. An insurance clerk deals with third party insurance company personnel and has regular contact with insurance company personnel, patients, patients families, physicians staff and physicians.

PRIMARY RESPONSIBILITIES & AUTHORITIES:

• Insurance maintains billings and makes inquiries (written or verbal) as to status of payment on a regular basis. Works cooperatively with Medical Records to secure correct coding and communicate to insurance companies regarding refunds when necessary. .
• Unapproved report is worked on the date of transmission. Claims are assigned a received date, full days, co-days, or life days information is needed.
• Approved report is worked on the date of transmission. In-patient claims are generated so the charges will pull to cover.
• Claims with missing information report is worked on the date of transmission. Claims are reviewed to correct claims that have missing or incorrect information before billing.
• Medical Records report of outpatient, in-patient, or surgery claims is worked on the date of transmission. These claims are checked for needed billing information and are set to ready to bill status.
• Claim edit reports are worked on the date of transmission. Claim edits are for the UB92 and 1500 claims, which are reviewed to correct any error before billing occurs.
• Transmission edits from CPSI, a fax is received from CPSI that list claims that have been returned due to an error on the transmission. Claims are reviewed and corrected for rebilling.
• Medicaid remittances are done by examining the remittance and finding each claim denied payment and the reason the claim was denied. Checking to make sure charges billed are paid. The claim is then resent to Medicaid for reconsideration for payment. Prep the remittance for posting for DP.
• Insurance Departments mailbox is checked daily for mail and other information submitted to the insurance department from other departments.
• At the end of each calendar year, all accounts are boxed for storage; alphabetized and dated with color-coded labels.
• Patient understanding of billing process is promoted.
• Maintains confidentiality of all information.

• Maintains neat and clean work area, takes out trash daily.
• Demonstrates knowledge of, and supports hospital mission, standards, policies and procedures, confidentiality standards, and the code of ethical behavior.
• Attends training sessions and meetings as required.
• Performs other duties as required.
• Maintains good communication skills and relationships with patients and clients.
• Each billing clerk will be responsible for preparing credit balances.
• Work closely with Collections to coordinate collections of outstanding balances after insurance pays or denies.

OTHER DUTIES AND RESPONSIBILITIES:

MINIMUM QUALIFICATIONS (EDUCATION, EXPERIENCE, SKILLS, ABILITIES):

• High school diploma or equivalent
• Prior experience in a business setting preferred
• Ability to enter and retrieve data from computer system
• Ability to operate modern office business machinery
• Ability to operate phone system
• Ability to interact with the public in a positive manner is absolutely essential

OTHER SPECIAL REQUIREMENTS (LICENSES, CERTIFICATIONS, REGISTRATIONS, ETC.)

N/A

PHYSICAL DEMANDS:

• Light lifting
• Ability to travel independently throughout the hospital to access information from other departments
• Ability to sit for long periods of time

WORK ENVIRONMENT:

Office Setting

HOURS:

Monday Friday 8:00 A.M. to 4:30 P.M. Unless otherwise discussed with Supervisor