Reporting to the Director of Revenue Cycle the Medical Biller is responsible for the follow-up and collections of all open accounts and ensures prompt and accurate reimbursement. This position initiates outgoing telephone calls and responds to incoming telephone and in-person inquiries from insurance companies, patients, patients’ families and faculty practice staff regarding collection of payments and delinquent accounts.
Incumbent will be responsible for the daily processing and resolution of all ETM edit request categories from; write-off, appeals, authorizations, charge entry, coding, front-end issues, medical records, payment posting and underpayments.
Incumbent will be responsible for the weekly BAR/TES issues log and system edits such as BAR claim edits, patient statement edits, and E-Commerce edits.
Researches and responds to insurance requests. Addresses incoming correspondence and prepares correspondence to insurance companies, patient and/or guarantor, as necessary.
Contacts insurance companies and/or patient/guarantor through direct contact, letter, or other means of due diligence. Update the on-line system with accurate and complete information.
Assists in eligibility and works with the insurance company, patients and/or families in resolving charging and billing problems.
Reviews account history for third party sponsorship.
Establishes payment arrangements according to pre-set guidelines; documents terms in ETM.
High school graduate or GED certificate.
Good interpersonal, verbal, telephone and written communication skills in the English language.
Functional knowledge of basic computer operation and keyboard functions.
Ability to follow-through and handle multiple tasks simultaneously.
Ability to work independently.
Some knowledge of electronic billing systems.
Must be a motivated individual with a positive attitude and exceptional work ethic.
Computer software skills: Knowledge of and Proficiency with GE/ETM (IDX), CROWN Allscripts, Microsoft Word, Excel and E-mail, etc.)
Minimum of 6 months to one year experience in a physician billing or third party payor environment.
Medical terminology experience, familiar with CPT-4 and ICD-10.
Knowledge of contracts, insurance billing requirements and CMS 1500 claim forms, worker’s compensation, HMOs, PPOs, capitation, Medicare, Medicaid and compliance program regulations.