Facility Biller

Duties

• Reviews coding and corrects front-end rejections in a timely manner for resubmission.
• Affixes assistance with uploading of daily 837 files, monitoring unbilled accounts.
• Reprocesses rejections, files appeals for claim denials to ensure maximum reimbursement for services provided.
• Contacts insurance companies regarding outstanding insurance balances.
• Identifies what is needed for resubmission, checks eligibility, ensures authorization is on file, and verifies claim status on payer websites to ensure all the necessary billing information has been satisfied to resolve the account balance.
• Contacts patients for updated insurance information when necessary.
• Maintains oversight of Aged Trial Balance Report by identifying areas of concern which may cause cash delays.
• Solves issues involving third party payers. Communicates internal/external issues that cause cash delays in a timely manner.
• Answers patient calls and responds to questions in a timely manner.
• Ensures patient account billing information and account balances are up-to-date; makes necessary adjustments in the computer system and documents all activity taken on the account for an audit trail.
• All other duties as assigned.

Qualifications

• Demonstrates eligibility to work for any employer in the U.S.
• High school diploma, GED, or suitable equivalent required.
• Associate’s or Bachelor’s Degree in Business, Healthcare or related field preferred.
• 3+ years of Coding/Billing follow-up experience in revenue cycle functions for a large multi-specialty physician office or hospital setting, preferred.
• Billing and coding experience in one of the following areas; Neurosurgery, Orthopedic, Anesthesia, and In-patient, preferred.
• Certified Professional Biller CPB, Certified Professional Coder CPC through AAPC, OR Certified Revenue Cycle Specialist CRCS through AAHAM, preferred.
• Knowledge of eCare CMS, a plus.
• Knowledge of general principles in regard to medical billing including verification, authorization, posting charges, procedures, diagnosis, medical medical necessity as well as knowledge of federal, and state regulations and billing rules.
• Knowledge and understanding of CPT, HCPCS CCI, MUE, ICD-10, NCD, informational and payment Modifiers.
• Knowledge of commercial billing procedures across a variety of payer systems.
• Proficiency in Outlook, G-suite, Gmail Google Docs (Word, Excel).
• Demonstrated skills in verbal and written English communications for safe and effective patient care and to meet documentation standards.
• Committed to contributing to a positive environment, even in rapidly changing circumstances.
• Able to work in a fast-paced and stressful environment while maintaining positive energy.
• Willingness to participate in goal-setting and educational activities for professional advancement.
• Able to work compassionately with patients and coworkers to exhibit patient care second to none.
• Exudes respect and flexibility to impact the workplace in a positive manner.
• Detailed oriented, conscientious and committed to precision in work results.
• Ability to perform to a high level of accuracy.
• Friendly, empathetic & respectful.
• Reliable in work results, timeliness & attendance.
• Able to relate to and work effectively with a wonderfully diverse populace.

Benefits

• Paid Sick Time - effective 90 days after employment
• Paid Vacation Time - effective 90 days after employment
• Health, vision & dental benefits - eligible at 30 days, following the 1st of the following month
• Short and long-term disability and basic life insurance - after 30 days of employment