Job: FT- Insurance Biller

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Jobing Description

In order to be considered for an interview applicants must submit a cover letter and resume via email only. "Attn: Insurance Biller- Ivy" must be included in the subject line of your email. Only applicants that meet the criteria listed in the job description will be considered for an interview. Please submit cover letter and resume to the email address listed.

Summary: Under the direction of the Billing Supervisor, the Insurance Biller is responsible for all computerized and manual billing to patients, third party payers, and government/state/county funding sources and programs.  Responsible for correct coding implementation and compliance with procedures set by the department. 

Essential Duties/ Responsibilities:

1. Review of encounters for missing, incomplete, or inaccurate information such as missing diagnosis, procedure codes, program specifics, coding discrepancies, benefit coverage verification, etc…  Retrieval of required information by review of progress notes, action/telephone encounter sent to provider or site for clarification, etc...  Maintaining department productivity and compliance standards.

2. Claim creation for all billable charges with submission of clean claims and/or statements in compliance with correct coding initiatives and billing industry requirement.

3. Monitoring of system claim status categories assigned to be sure that all transactions are captured for month end close. 

4. Register patients as needed.

5. Reviews and processes patient eligibility with accuracy, to include acquisition of authorization numbers as needed.  Apply SFS discounts as necessary.

6. Reviews and corrects daily input in Practice Management system before finalizing transactions. 

7. Posting of payments and account balance adjustments.

8. Monitoring/Reporting of discrepancies in contractual allowances, denial & payment trends, coding issues, and benefit changes.

9. Processing of claim errors as assigned in a timely manner assuring department deadlines are met (i.e.: clearing house rejections, insurance rejections, ERA payer denials, third party vendor error reports, etc...).

10. Review and processing of claim aging as assigned to include rebills/tracers, corrected claim submissions, appeals, etc…  

11. Responsible for month end reporting and monitoring of funding sources as assigned.       

12. Discusses billing questions with patients and sites, as well as handle inquiries from third parties.

13. Negotiates payment plans with patients and forwards information to appropriate team for follow up.   

14. Adjust patient and insurance balances on accounts as appropriate and resolve account questions and/or problems. 

15. Assist in maintaining an orderly filing system for all processes in regards to encounters as well as maintaining compliance standards.

16. Provide customer service internally and externally with professionalism, courtesy, knowledge, and follow through. 

17. Handle Site/Insurance/Patient correspondence received in the department with a sense of urgency and appropriate follow through. 

18. Maintaining department productivity and quality standards at all times.

19. Attend educational workshops as directed. 

20. Attend staff meetings and clinic in-services.

21. Other duties/projects as assigned.

Quality Management:

1. Display knowledge of normal signs of human development and ability to assess and provide age appropriate care.

2. Contribute to the success of the organization by participating in quality improvement activities

Customer Relations:

1. Respond promptly and with caring actions to patients and employees.  Acknowledge psychosocial, spiritual and cultural beliefs and honor these beliefs.

2. Maintain professional working relationships with all levels of staff, clients and the public.

3. Be part of a team and cooperate in accomplishing department goals and objectives

Safety:

1. Maintain current knowledge of policies and procedures as they relate to safe work practices.

2. Follow all safety procedures and report unsafe conditions.

3. Use appropriate body mechanics to ensure an injury free environment.

4. Be familiar with location of nearest fire extinguisher and emergency exits.

5. Follow all infection control procedures including blood-borne pathogen protocols

HIPAA/Compliance:

1. Maintain privacy of all patient, employee and volunteer information and access such information only on a need to know basis for business purposes.

2. Comply with all regulations regarding corporate integrity and security obligations. Reports unethical, fraudulent or unlawful behavior or activity.

Qualifications

Skills: Attention to detail and accuracy; Motivated self-starter; Enthusiastic, Ability to work efficiently in a fast paced environment with ability to follow through.  Ability to time manage and multitask.  Possess strong ICD/CPT/HCPCS coding skills, claims follow up experience, intermediate to advanced Excel skills, and ability to demonstrate a comprehensive understanding of insurance eligibility and coverage.  Excellent customer service and phone skills required as well as the ability to handle difficult situations; Bilingual English/Spanish or English/Arabic preferred.

Education: HS diploma/ GED required, Medical Biller certification or equivalent.

Experience: 1-2 years Medical Insurance Billing experience required.

Acknowledgement:

Neighborhood Healthcare is an Equal Opportunity Employer.  We encourage applications from all individuals regardless of race, religion, color, sex, pregnancy, national origin, sexual orientation, ancestry, age, marital status, physical or mental disability or any other protected class, political affiliation or belief.