Biller

Description

The RCM Biller must be familiar with all aspects of Electronic Billing for Residential Detox, Partial Hospitalization and Intensive Out-Patient care in the Co-Occurring and Substance Abuse field. Primary focus will begin with compiling information and submitting to insurance companies in a timely manner. The focus of our RCM Biller is to manage the claims process allowing the clients clinical and medical staff time to a focus on providing the highest level of care for their client. Must be familiar with or have an understanding of insurance benefits including deductibles and out-of-pocket costs associated with In-Network and Out of Network insurance providers. Experience in the Mental Health/Addiction space, Medical Billing is preferred.

Responsibilities:

• Using coded data to produce and submit claims to insurance companies
• Working directly with the insurance company, healthcare provider, and patient to get a claim processed and paid
• Reviewing and appealing unpaid and denied claims
• Claims review prior to submission, fixing any rejected claims
• Managing the facility’s Accounts Receivable reports
• Review clinical documentation from EMR billing reports for accurate and complete diagnostic and procedure information.
• Review all departmental billing guides, payer rules, and any changes to billing guidelines
• Maintain current working knowledge of Medicare billing regulations and requirements
• Prepare clean claims to be sent to insurance companies electronically
• Prepare electronic claims on a UB04 or CMS 1500 format
• Actively works with the Utilization Review Department if an issue with a patient's authorization is presented
• May be required to request diagnosis or other data from providers when not recorded in the clinical documentation in the EMR , or if the information is incomplete.
• Determines the correct sequence of primary and secondary diagnoses according to provider documentation.
• Applies knowledge of ICD-10, CPT, HCPCS, and modifiers to all provider coding and billing assignments.
• Verify completeness and accuracy of all claims prior to submission.
• Ensure claims are submitted with a goal of zero errors.
• Work efficiently and effectively in the EMR and Billing software system to ensure clean claims are sent to the payers appropriately.
• Maintains the strictest confidentiality; and adheres to all HIPAA guidelines/regulations.
• Responsible for other job related duties as assigned by the Billing Director  Assistant Director of RCM.
• Maintains confidentiality of client information and records; and of facility proprietary, privileged, and/or confidential information.
• Communicates and problem solves via the chain of command.
• Seeks corrective criticism and has the ability to evaluate suggestions objectively.
• Reported to work as assigned.
• Completes daily tasks as assigned and documents the delivery of all client services.
• Maintains acceptable overall attendance.
• Promotes a favorable/positive work atmosphere.
• Attends in-services and educational training as necessary and as assigned.
• Seeks out learning experiences and incorporates new knowledge into practice.
• Maintains flexibility and adaptability to expected and unexpected changes in the work environment.
• Reports incidents, accidents, and occurrences in accordance with policies and procedures.
• Maintains safety of the physical environment.
• Performs all other tasks as assigned.
• The Biller is responsible for follow-ups pertaining to pending items and/or missing documentation.
• The Biller is responsible for working rejection. 
• Participate in a billing and collection related meetings to discuss new and on-going account resolution
• The Biller must review each billable service in the EMR ensuring the appropriate documents are signed, services rendered are reaching the LOC criteria and all potential revenue is maximize
• Understanding of being HIPAA Compliant with all patient information

Experience:

• A minimum of 1 to 2 years’ experience in billing, preferably in a healthcare setting.
• Previous Billing experience preferred.
• Substance Abuse experience preferred

Education:

• Preferred some college or related vocational training.

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Professional development assistance
• Tuition reimbursement
• Vision insurance

Schedule:

• 8-hour shift
• Monday to Friday

Ability to commute/relocate:

• Delray Beach, FL 33445: Reliably commute or planning to relocate before starting work (Required)

Work Location: In person

WORK ENVIROMENT & PHYSICAL REQUIREMENTS

• Work is performed in an office setting.
• Prolonged periods sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at a time.
• Physical demands of position: sitting, standing, walking, typing, phone communication, face to face conversation.

Job Type: Full-time

Qualifications

Behavioral and mental health experience  is a must, but not limited to Inpatient, Outpatient, mental health, and substance abuse billing(at least 3 years)

Experience using medical billing software- Collaborate MD-Kipu-Best Notes-

Ability to prioritize tasks properly

Organized and able to multitask

Excellent verbal and written communication skills

Proficient in Microsoft Office Suite (Excel, Word, PowerPoint, Outlook)