MEDICAL BILLER

Description

MEDICAL BILLER

Department: Billing

Job Scope: Biller/Coder

Date Updated: May 2022

Direct Report: Billing Manager

FLSA Status: Non-Exempt/Full-Time

Hours Worked: 40 /week

Medical billers serve as intermediaries between medical providers, patients and health insurance companies. They ensure that payment for medical services is received in a timely manner

Duties:

1. Manage the facility’s accounts receivable reports.
2. Accurately file claims with insurance carriers and third-party administrators.
3. Review and appeal unpaid, denied or underpaid claims for proper payment.
4. Handle collections on unpaid accounts; both insurance and self-pay.
5. Answer patient billing questions.
6. Verify patients’ insurance benefits and notify patient of any outstanding balance due.
7. Obtain authorization for procedures performed at Pueblo Medical Imaging.
8. Work with government and commercial payers regarding issues with claim submissions.
9. Perform other duties and/or special projects as assigned.

Qualifications

Two years previous billing experience.
Knowledge of Nevada insurances and Medicare/Medicaid regulations.
Knowledge of laws on debt and collection.
Knowledge of medical coding.
Knowledge of medical terminology.
Maintain confidentiality of all company and patient information at all times, as required by the facility and HIPAA guidelines.
Must be able to perform essential job functions efficiently

• Ability to use excellent communications skills.
• Ability to manage stress appropriately.
• Ability to manage time efficiently.
• Ability to handle multiple projects and meet deadlines.
• Ability to work alone and/or with others effectively.
• Possesses common sense understanding to carry out instructions furnished in written, oral and diagram form.

Physical Demands:

• Standing - This position frequently requires standing for frequently for patient assessment, positioning patient for procedure, communicating with all facility personnel, faxing, copying and completing other job-related duties.
• Walking - This position consistently requires walking short distances of up to 100 yards to communicate with patients, staff, doctors, vendors, and direct report.
• Sitting - This position consistently requires sitting to configure and enter data needed for electronic medical charts, diagnostic procedures on a RIS and PACS computer system and other essential job duties.
• Lifting - This position consistently requires lifting objects weighing a minimum of 50 lbs. to carry out essential job duties and deal with patients with physical disabilities and/or disorders.
• Carrying - This position occasionally requires carrying objects weighing up a maximum of 50 lbs. for short distances to carry out essential job-related duties.
• Reaching - This position frequently requires reaching with hands and arms approximately 3 ft. all directions to assist patients while at the facility for a required procedure and/or perform various job-related functions.
• Handing - This position frequently requires handing paper, clipboards or objects to patients, staff, doctors, and vendors to carry out essential job duties.
• Bending - This position frequently requires bending/leaning from the waist in all directions to carry out essential job duties.
• Kneeling - This position frequently requires kneeling to assist patients or carry out essential job duties.
• Speaking - This position consistently requires excellent verbal abilities to communicate with patients, co- workers, doctors, and vendors on a daily basis.
• Hearing - This position consistently requires auditory abilities to efficiently listen to patients, doctors, vendors, co-workers, and staff to carry out essential job duties.
• Seeing - This position consistently requires acute visual abilities to conduct requested medical procedures, see the computer to enter patient data and document necessary information to become part of the patient’s electronic chart, read patient related documents, physician requests, and other job- related paperwork to carry out essential job duties.

           
Is this position closely, moderately or minimally supervised?   Closely
Explanation: This position is closely monitored by the Medical Billing Manager.

Does this position have supervisory responsibility (i.e. responsible for hiring, firing, 
performance appraisals, etc.)?   No

Does this position have access to confidential information?   Yes
Explanation: This position has access to confidential information such as social security numbers, dates of birth, credit card numbers, bank account information and HIPAA information for patients scheduled through our RIS system.

Does this position have access to or handle company funds?   Yes
Explanation: This position has access to limited company funds of co-pays and deductibles collected over the phone. The payments are collected by obtaining credit card information on a daily basis from patients seen at the facility.

Is it important to this position the incumbent be able to read, write and communicate fluently in English? Yes
Explanation: Most affiliated personnel (i.e. staff, doctors, vendors, and affiliated hospital/locations) and a majority of our clients communicate with our facility in English. Bilingual abilities are always preferred.

What kind of work experience (including length of time), training, and/or level of education is necessary for this position? This position requires a minimum of two years of previous medical billing, radiology preferred. This position must have extensive knowledge of Nevada insurance carriers. Previous experience in collections, coding, verifications and authorizations is required.

List any technical skills (typing, computer skills, etc.): The skills required by this position include, but are not limited to, typing, faxing, scanning, copying, and computer literacy in Word, Excel and Billing software.

What other special training and/or abilities are necessary to qualify for this position? This position must possess skills, aptitudes and abilities to perform each essential job duty proficiently. Superior interpersonal and problem-solving skills are required for this position to communicate with patients, staff, referring physicians and management.

Working Conditions

Are there particular working conditions associated with this position that should be noted (i.e., working environment, hours of work, travel, work space, etc.)?   Yes
Explanation: This position will carry out his/her duties in an average size office space that is generally very quiet. This space will be shared with departmental staff. The hours are approximately 8:00 a.m. to 5:00 p.m. Some overtime may be required. Some travel may be required to affiliated locations.