Medical Biller

Description

Are you Collaborative, Adaptable, Respectful and strive for Excellence?

If so, you share our C.A.R.E. with Compassion core values, and we invite you to apply to become part of our Team.

JOB DESCRIPTION

JOB TITLE: Medical Biller STATUS: Non-Exempt

REPORTS TO: Chief Financial Officer LOCATION: Spokane, WA

SCHEDULE: M-F, 8am - 5pm FT/PT: Full Time

BASE PAY: $20.00/hour

JOB SUMMARY

To ensure prompt and correct billing of all contracted and non-contracted commercial and private carriers minimizing denials and maximizing reimbursement. With an emphasis on problem solving through research and interface with Therapeutic Solutions/Psychiatric Solutions staff and physicians in order to obtain maximum reimbursement as expediently as possible.

DUTIES & RESPONSIBILITIES

• Process private and commercial billings and correspondence.
• Responsible for monitoring the unbilled, denied, rejected and aging accounts and the handling of all delinquent insurance accounts.
• Communicate with patients by telephone, mail or in person to answer questions or resolve issues on their account.
• Other duties and projects as assigned.

ESSENTIAL REQUIREMENTS

• Minimum of one-year insurance billing experience in a medical office.
• Proficient computer skills including Microsoft Suite, electronic health records and commercial billing.
• Excellent verbal and written communication skills.
• Positive attitude and a team player.
• Well-developed ability to collaborate and adapt to changes in the workplace.
• Ability to exercise good judgment and discretion at all times.
• Ability to read, write and comprehend basic medical terminology.
• Ability to work well and accurately under pressure.
• Ability to organize and complete work in an efficient and effective manner while focusing on detail and timeliness.
• Maintains confidentiality at all times.

DESIRED QUALIFICATIONS

• Ability to work in a close cooperation with other personnel, and a mature and businesslike manner.
• Self-directed with the ability to work with little supervision.
• Flexible and cooperative in fulfilling all obligations.
• Ability to maintain regulatory requirements including Allstate, federal and JCAHO regulations.
• Represents the organization in a process positive and professional manner.

PHYSICAL DEMANDS

For physical demand of position, including vision, hearing, repetitive motion, and environment, see following description: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising client care.

MEDICAL BILLER EVALUATION CRITERIA

Process private and commercial buildings and correspondence.

• Proficient in the use of automated billing systems.
• Proficient with electronic health records and other software applications.
• Review and process professional, program and other service line charges by way of electronic or paper claims.
• Review all claims for completeness and submit with necessary documentation.
• Research problems by using Accounts Receivable reports and claim follow-up by phone calls and/or letters.
• Update insurance records if necessary to ensure correct information on claims.
• Understands commercial insurance and insurance contracting relationships.
• Responsible for balancing all monies posted.

Responsible for monitoring the unbilled, denied, rejected and aging accounts and the handling of all delinquent insurance accounts.

• Process the unbilled report and payment challenges on a daily basis.
• Post all insurance and patient payments and denials on a daily basis via incoming mail and by pulling EFTs online and through E-remittance.
• Responsible for working denials and rejected claims received by researching why claims denied and correct them in order to resubmit for claim reimbursement; Send appeals as needed.
• Review the unapplied report and work/process all needed insurance and/or patient refunds on a monthly basis.

Communicates with patients by telephone, mail or in person to answer questions or resolve issues on their accounts.

• Send out patient statements as needed.
• Ability to set up payment agreements and/or begin the collection process according to the collection policy.
• Work on the patient outstanding collection report with or without delinquent accounts as needed.
• Complete insurance eligibility checks according to the assigned schedule.
• Possess excellent written and communication skills.

Other duties and projects as assigned.

• Actively participates in billing meetings as well as other inter-departmental and company-wide meetings and/or committees.
• Willingly accepts and completes other duties and projects as assigned by the Billing Manager and/or Chief Financial Officer.

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