What are the responsibilities and job description for the Insurance Biller Collector - Patient Accounting MG position at Saint Mary's Health Network?
Overview
Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Saint Mary's Medical Group is affiliated with Saint Mary’s Regional Medical Center, one of the nation’s “100 Top Hospitals” and “A” rated for patient safety. We offer incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
Responsibilities
The Biller is responsible for submitting claims to the appropriate intermediaries and to ensure that procedures and charges are coded in compliance with all payers including Medi-Cal and/or Medicare regulations. Responsible for obtaining required authorizations necessary for the processing and payment of claims. The Biller is responsible for the follow-up and denial management as necessary for final resolution. Responsible to identify the various types of diagnosis and procedures codes (ICD9, CPT, HCPCS, DRG) as they relate to reimbursement. Communicates clearly and efficiently by phone and in person with clients and staff members. Maintains productivity standards and reports. Obtains updated demographic information and all necessary information needed to comply with the various Government Programs billing requirements. Operates computer to input follow up notes and retrieve collection and patient information. Maintains proficiency in Medical Terminology
Qualifications
EDUCATION, EXPERIENCE, TRAINING
Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Saint Mary's Medical Group is affiliated with Saint Mary’s Regional Medical Center, one of the nation’s “100 Top Hospitals” and “A” rated for patient safety. We offer incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
Responsibilities
The Biller is responsible for submitting claims to the appropriate intermediaries and to ensure that procedures and charges are coded in compliance with all payers including Medi-Cal and/or Medicare regulations. Responsible for obtaining required authorizations necessary for the processing and payment of claims. The Biller is responsible for the follow-up and denial management as necessary for final resolution. Responsible to identify the various types of diagnosis and procedures codes (ICD9, CPT, HCPCS, DRG) as they relate to reimbursement. Communicates clearly and efficiently by phone and in person with clients and staff members. Maintains productivity standards and reports. Obtains updated demographic information and all necessary information needed to comply with the various Government Programs billing requirements. Operates computer to input follow up notes and retrieve collection and patient information. Maintains proficiency in Medical Terminology
Qualifications
EDUCATION, EXPERIENCE, TRAINING
- Previous Billing Experience within a hospital Business Office Required.
- Previous experience with government programs and collections preferred.
- Knowledge of medical terminology
- Effective written and verbal communication skills
- Ability to multi-task, prioritize needs to meet required timelines
- Analytical and problem-solving skills
- Customer Services experience required
- High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires)
