Medical Biller

Qualifications

• Must demonstrate strong critical thinking skills, take initiative, be self-motivated and perform thorough research in order to be able to accomplish day to day tasks
• Knowledge of electronic health record system and filing records used for billing
• Adhere to dress code, appearance is neat and
• Maintain current license, registrations and/or certifications
• Maintain patient confidentiality at all
• Maintain regulatory requirements, including all state, federal and local
• Represent the organization in a positive and professional manner at all
• Comply with all organizational policies and standards regarding ethical business

Job Summary

The Biller performs complex clerical and accounting functions for patient billing, including verification of invoice information, maintenance of third-party billing records, and resolution of problems. Follows up on submitted claims and patient billing; resubmits claims or correct inaccuracies. May handle cash items and accounts receivable posting. Works with others in a team environment.

Duties / Responsibilities:

• Works with electronic health record vendor and clearinghouse on Electronic Data Interchange (EDI) issues and system upgrades to maximize practice management system utilization.
• Maintains regulatory compliance ensuring policies are accurate and up to date.
• Maintains working knowledge of FQHC billing rules, CPT, ICD-9, and ICD-10 coding,
• Collects and maintains data for Uniform Data System reports annually
• Prepare, submit, and follow up on all insurance claims to ensure timely billing and payment of secondary insurance companies and Medicaid/Medicare.
• Performs EOB/Denial management daily to maintain a current and up to date status on all denials. Corrects and submits claims for re-bill to insurance carriers weekly.
• Posts payments (electronically and manually) and processes all payments to patients and insurance companies in which overpayments have occurred.
• Performs electronic billing processing/batch submission daily and reviews all claims rejected by clearinghouse and corrects claims and resubmits the claims daily.
• Problem solving of billing problems as they occur and early communication with COO/CAO/EVP regarding any unusual occurrences related to billing.
• Communicates with accounting department at Unicare Community Health Center, Inc. regarding billing and posting issues.
• rmation seminars as necessary for compliance with billing requirements of various payers.
• Knowledge of and compliance with Unicare Community Health Center, Inc. Policies and Procedures, especially as related to billing, accounting, and data management.
• Answers all patient account inquiries made from patients and payers; Utilizes computer & EHR to run printouts for follow-up on claim status, claims ets to be billed and audit reports as needed; Files billing documents as directed by the departmental processes.
• Must demonstrate strong critical thinking skills, take initiative, be self-motivated and perform thorough research in order to be able to accomplish day to day tasks.
• Maintains strictest confidentiality, adheres to all HIPPA guidelines and regulations.
• Must be able to adhere to the Attendance policy and procedure; must maintain a clean, professional demeanor in all situations, ability to work cohesively within a group setting.
• Knowledge of electronic health record system and filing records used for billing.
• Computer use for research, data entry, record keeping, and business communication via email.
• Collaborate with EHR team on Provider/Biller

Requirements

• Adhere to dress code, appearance is neat and
• Maintain current license, registrations and/or certifications.
• Maintain patient confidentiality at all
• Report to work on time and as
• Maintain regulatory requirements, including all state, federal and local
• Represent the organization in a positive and professional manner at all
• Comply with all organizational policies and standards regarding ethical business
• Communicate the mission, ethics and goals of the
• Participate in performance improvement and continuous quality improvement

Position Requirements
Qualifications

• Minimum of 1 year of relevant experience and/or training, or equivalent combination of education and experience and understanding of billing process for private and public health insurance programs.
• Skilled in Microsoft Office (Word, Excel, Outlook) and E-Clinical Works (EHR system).
• Ability to gain proficiency on additional computer programs required to perform the job.
• Good verbal and written communication skills, including spelling and English grammar with ability to understand and complete oral and written instruction.
• Spanish-speaking preferred but not required.
• Reliable Transportation.