Medical Biller II

Job Description

Job Description

SUMMARY :

This position is responsible for supporting the Professional Medical Billing team by posting payments, understanding of insurance remittance, remark codes, capturing / working denials, and working outstanding accounts receivable (A / R) balances and other assigned duties as needed. Maintaining accuracy of lockbox and ensuring each month close out balances. Will also be responsible for assisting in analysis and resolutions of clinic reimbursement issues, clinical statistics, recommending CDM updates for clinic services and assisting Management with other billing responsibilities as assigned.

ESSENTIAL FUNCTIONS :

• Perform posting charges and completion of claims to payers on time
• Review transmitted claim via clearing house, working rejected claims as needed
• Review patient bills for accuracy and completeness, and obtain any missing information
• Prepare, review, and transmit claims using billing software, including electronic and paper claim processing
• Follow up on unpaid claims within a standard billing cycle timeframe
• Check each insurance payment for accuracy and compliance with contract discount
• Call insurance companies regarding any discrepancy in payments, if necessary
• Identify and bill secondary or tertiary insurances
• Review accounts for insurance or patient follow-up
• Research and appeal denied claims
• Answer all patient or insurance telephone inquiries on assigned accounts
• Update billing software with rate changes
• Reading and interpreting insurance explanation of benefits (EOBs)
• Understanding and knowledge of ICD-10, CPT Codes, and HCPCS Level II Codes
• Posting ERAs, paper checks, credit cards, and balancing lock box
• Provides guidance to clinical staff in regards to insurance updates, edit updates, and payer updates
• Assist Medical Biller 3 with assigned duties
• Minimal supervision may be required by billing manager

OTHER RESPONSIBILITIES :

Within other departments, patients, families, the community, and medical staff

SUPERVISORY RESPONSIBILITIES : None

EDUCATION, KNOWLEDGE, SKILLS, ABILITIES, AND EXPERIENCE :

LICENSES AND CERTIFICATIONS :

Basic Life Support

AGE OF POPULATION SERVED :

Newborn  Infant / Pediatric  Adolescent  Adult Geriatric  All X  No Patient Care

PHYSICAL REQUIREMENTS :