Medical Biller

Duties And Responsibilities

• Demonstrates proficiency with Electronic Medical Records (EMR) and when needed, enters data into computerized system.
• Posts charges and claims to payers in a correct and timely fashion; works claims and claim denials to ensure maximum reimbursement for services provided.
• Responds to questions and complaints from patients or insurance companies.
• SUBMIT billing data/information to medical and insurance providers; requests any missing patient information as needed.
• Audits the front desk on collection of payment, entering patient information correctly into the EMR, and assigning appropriate insurance type(s) or SFS data.
• Manages the flow of the front desk and assists with patient complaints.
• Safeguards internal controls and ensures compliance with regulatory agencies.
• Captures and manages accounts receivables, prepares monthly patient statements, and creates paper and electronic records of documentation related to billing/denials/payments, etc.
• Arranges payment plans and timelines for payments.
• Ensures correct codes are included in claims submitted to Medicaid/Medicare/Commercial; Performs Medicaid/Medicare audits as needed.
• Reviews EOBs looking for trends in conjunction with the accounting department.

Administrative Duties

• Maintains customer confidence and protects operations by keeping sensitive information confidential and always maintaining patient confidentiality.
• Develops and maintains a tracking and dating system for incoming and late payments.
• In conjunction with the accounting department, monitors and resolves financial discrepancies.
• Provides reports as requested to the Revenue Cycle Manager, Accountant, CEO, or Board of Directors regarding monthly billing, numbers of claims submitted, expected payments, issues, etc.

Other Duties

• Promotes and demonstrates Hope values of: Gospel motivation, Prayer, Excellence, Stewardship, Patience, Thankfulness, Humility, Service, Dignity through Relationship and Hospitality and Joy.
• Always maintains and ensures patient confidentiality.
• Always Maintains a courteous and professional demeanor; greets individuals and patients as they enter and exit the clinic; facilitates appropriate communication and interpersonal skills with all staff members, volunteers, and patients.
• Maintains a safe, secure, and healthy work environment by establishing and following standards and procedures; comply with legal regulations.
• Ensures front office and clinic policies and procedures (as applicable) are always followed.
• Updates job knowledge by participating in educational opportunities; reading professional publications.
• Attends and actively participates in staff meetings.
• Performs all other duties as assigned.

Requirements

• Fluency in English and Spanish - required.
• Billing and Coding Certificate - required.
• At least (1) one year experience in medical billing – preferred.
• Experience in a similar healthcare environment - preferred.

Key Competencies For Success

• Faith to believe that Hope is a ministry of God, exemplifying the love of Christ, and held and directed by the Holy Spirit.
• Knowledge of CPT, HCPCS and ICD-10-CM coding.
• Knowledge of medical billing, particularly for Federally Qualified Health Centers (FQHCs).
• Knowledge of and skill in operating the electronic medical record (EMR) system, office equipment (calculator, copy/fax machine, telephone), personal computer systems (word processor, databases, email).
• Outstanding ability to build interpersonal relationships at all levels.
• Excellent communication skills, both written and verbal.
• Demonstrated passion for community health care.
• Ability to think strategically and make good decisions under pressure and within established timelines.
• Ability to work independently and collaboratively through teamwork.
• Proven ability to maintain integrity and sense of calm in a fast paced and high-demand environment.
• Proven ability to manage performance goals and maintain an organized workflow.
• Ability to analyze and process high volumes of information; multi-task, manage priorities; follow through.
• Ability to interact with people from all ethnic backgrounds, ages, and lifestyles.