Full Cycle Biller

Sante Health System in Fresno, CA is eager to find a Full-Cycle Biller to join one of our team. This position is responsible for performing the life cycle of the revenue cycle process. This includes intake of charges, analyzing documentation to verify correct coding, posting of charges and insurance/patient follow-up until charge is satisfied. If you have data entry experience and an excellent team player with exceptional organizational and people skills, apply today!

QUALIFICATIONS

• Excellent attendance & communication
• Medical office & NextGen experience preferred
• Knowledge of billing guidelines - Insurance Billing, Accounts Receivable, Refunds, Charge Entry, Reconciliation, CPT Codes & ICD-10
• Knowledge of Medicare, Medi-Cal, Commercial PPO & HMO, Medi-Cal, IPA & Managed Care Plans
• Proficient in Microsoft Word, Excel, Adobe

Candidates should have exceptional people and communication skills, be highly skilled in multi-tasking in a fast paced environment, a commitment to achieving a high level of accuracy and attention to detail, and a no-task-too-small approach to the work.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Under the direction of Manager, the Full-Cycle Biller is responsible for:
• Analyzing encounter forms/superbills for accuracy, reasonableness and completeness.
• Accurately and timely entering charges to expedite patient and third party payments.
• Assisting with reviewing and/or entering diagnosis and procedure codes.
  
• Updating account information, as needed, including patient demographics and insurance information.
• Balancing of daily data entry batch transmittal forms.
• Communicating discrepancies and potential errors or trends to manager.
• Compiling daily individual productivity reports.
  • Reviewing and analyzing aged account receivables, determining and completing the best course of action to ensure payment will be received, including:
  • Reviewing and responding to denials and correspondence
  • Submitting corrected claims
  • Adding/removing modifiers
  • Contacting the patient if additional information is needed
  • Contacting the payer to discuss status and request review
  • Attaching additional documentation to claims, as needed (i.e. Medical records)
  • Filing check tracers
  • Filing appeals and re-opening requests
  • Determining if balance should be assigned to Collection Agency
  • Setting up payment plans with patients and monitoring adherence
• Monitoring unapplied balance/overpayments per company guidelines.
• Communicating with sites as directed.
• Assisting sites and patients with questions and concerns.
• Notating and documenting all work performed, as directed.
• In the spirit of teamwork, employees are expected to follow any other job-related instructions and to perform any other job-related duties as requested.

KNOWLEDGE, SKILLS AND ABILITIES

Employee should consistently demonstrate:

• Excellent verbal and written communication
• Ability to multi-task in a fast paced environment, work independently and stay on task under general supervision.
• Attention to detail and proficient follow-up skills
• Maintain strictest confidentiality per HIPAA and company policy
• Ability to problem-solve, plan, prioritize and complete tasks
• Ability to deal effectively with changing priorities, deadlines and plans of action
• Skill in establishing and maintaining effective working relationships
• Ability to work to precise and established standards of accuracy

ABOUT SANTE HEALTH SYSTEM

Sante Health System is a Management Services Organization that serves multiple clients. "Sante" is the French word for health. Our name symbolizes our commitment to good health, progressive care, and leadership in our community.

Sante is one of the largest healthcare claims and billing management companies in Central California. The strength of Sante is the extraordinary network of physicians, health plans, and other health service providers it offers the people of our valley. Sante coordinates with physicians, health plans, hospitals and ancillary providers to ultimately benefit the patient in a managed care environment. Sante Health System provides numerous client services such as billing, claims processing, contracting, credentialing, finance, human resources, information services, marketing/communications, physicians services, practice management, provider relations, quality improvement and utilization management.

Sante is celebrating over 25 years of service to the community. We deeply understand that we would not be successful in enhancing the quality of life of our patients without our incredible team. This is why we have created a work culture that is comprised of talented, driven, dedicated, innovative and service driven professionals. We provide competitive pay, excellent benefits including medical, dental, vision and life insurance, 401k retirement plan, paid time off, and opportunities for advancement. Being part of our team is like being part of a big family. Join our team and make Sante Health System your home away from home.

Apply today for this biller position using our initial 3-minute, mobile-friendly application. We look forward to meeting you!

www.santehealth.net