Insurance Biller - Hybrid

Billing

This position is responsible for timely and accurate billing of assigned accounts to a variety of payors using the computerized patient accounting systems. Responsibilities also include staying current with UB-04 and HCFA-1500 billing requirements, HIPAA Regulations, Payor Regulations, and Payor Contractual Agreements to ensure proper billing and compliance.

• Review bills and related information for accuracy and reasonableness of charges
• Audit claims for overlap (charges, dates, coding, condition codes, modifiers, discharge status) and resolves issues with medical records and revenue department heads.
• Work Specific Reports (as applicable)
• Submit bills to payers electronically if possible, otherwise paper
• Proficient in Commercial/Medicare/Medicaid Government regulations and reimbursement policies
• Proficient in third party contractual agreements and regulations to apply requirements for accurate billing and to make recommendations for system changes as needed
• Compute required adjustments to bills, balances to support, and inputs debits/credits to billing system to appropriate codes to ensure accurate billing
• Follow up on unbilled claims pending Medical Records coding, claim forms, etc. in order to bill on a timely basis
• Take appropriate action to resolve claims
• Elevate serious barriers to claim resolution to appropriate management
• Execute any, and all, steps to resolve unpaid, including but not limited to; rebill of claim
• Seek opportunity for training and informs supervisor of all training needs

Job Description

Demonstrate respect, dignity, kindness, and empathy in each encounter with all patients, families, visitors and other employees regardless of cultural background.

Expected Reimbursement

Meets productivity and quality standards on a weekly basis

Continuing Education & Training

Seeks opportunity for training & informs supervisor of all training needs

Education, Credentials, Licenses

High School diploma or GED

Specialized Knowledge

PC Skills, including Word and Excel

Detail Oriented

Customer Service Skills

Excellent Communication Skills

Billing or Follow Up experience

Kind And Length Of Experience

One year’s experience in billing or follow-up activities

Experience in customer service, billing or related field.

FLSA Status

Non-Exempt