Medical Biller

Overview

Medical Biller Jobs in Santa Maria, USA at Community Health Centers of the Central Coast, Inc.

Position: Medical Biller I

Job Title: Medical Biller I

Department: Patient Accounting

Reports To: Business Office Manager

FLSA Status: Non-Exempt

Wage Range

• Medical Biller I: $25.00 – $27.56 per hour

Summary

Under the direct supervision of the Director of Business Office, the Medical Biller is responsible for utilizing both practice management systems;
Athena and Next Gen. The employee is responsible for preparing and posting fee tickets for various sites and programs. The Medical Biller will post and balance payments received, handle all incoming billing calls, and work aging for various programs and payers. The employee will send patient statements, run month end reports, and submit third party claims electronically and/or manually. The employee will ensure that all providers and facilities are paneled with the various insurances and state programs.

The Medical Biller will maintain current knowledge of CPT, HCPC and ICD
10 coding practices. The Medical Biller will also maintain knowledge of all programs and payer source requirements and guidelines. The employee will adhere to HIPAA guidelines and regulations. It is the primary purpose of CHCCC to provide the highest quality of total care possible to the patient population it serves. Such a level of quality depends ultimately on the staff’s desire and ability to work together, individually, and as a team.

The employee is expected to be professional, punctual, maintain regular attendance, be cooperative, organized, and enthusiastic at all times.

Essential Duties and Responsibilities Medical Biller I Responsibilities

• Post daily fee tickets and/or incoming mail for various sites, programs and some specialty services electronically and/or manually.
• Review fee tickets for accuracy of CPT, HCPC, and ICD
  10 coding.
• Check for covered services per payer source to avoid claim denials.
• Check claims dashboard in Athena and Next Gen for any missing fee tickets and check claim worklist inbox for MGR holds.
• In Athena and Next Gen, run missing fee ticket report to ensure that all fee tickets have been posted or voided.
• Assist patients with billing and insurance questions.
• Apply payments to charges submitted and balance payment roster.
• Audit sliding fee payer for accuracy and documentation that supports the sliding fee payment scale.
• View inbox for billing messages and address patients’ issues.
• Demonstrates adherence to and observes all safety policies and procedures, inclusive of infection control rules and regulations.
• Maintains and adheres to HIPAA, employee confidentiality, and privileged communications (patient, employee, and corporation).
• Demonstrates cultural sensitivity and competence.

Medical Biller II Responsibilities

• Reconciles deposits to bank activity to ensure that third party payments are posted and balanced monthly.
• Submits third party claims electronically and/or manually.
• Identifies patient reimbursement issues ensuring that claim denials and appeals are efficiently processed and resolved.
• Work accounts receivable aging report for billing errors, denials, and coding errors and make necessary corrections for reimbursement or bad debt write-off.
• Run various month end reports to balance monthly billing activities.
• Demonstrates adherence to and observes all safety policies and procedures, inclusive of infection control rules and regulations.
• Maintains and adheres to HIPAA, employee confidentiality, and privileged communications (patient, employee, and corporation).
• Demonstrates cultural sensitivity and competence.

Medical Biller III Responsibilities

• Updates and maintains both practice management systems;
  Athena and Next Gen.
• Process EDI files for dental services in Next Gen.
• Ensure that aging and denial reports are audited ensuring that they are worked appropriately and in a timely manner.
• Assist billing staff with coding, posting, and claim denials.
• Ensure that specialty services (impatient/surgeries) are coded correctly for full reimbursement.
• Set up training curriculums for various job functions (posting, claims denial, procedure codes, diagnosis and modifiers) pertaining to payer(s) guidelines.
• Knowledge of all payers programs and billing…

Title: Medical Biller

Company: Community Health Centers of the Central Coast, Inc.

Location: Santa Maria, USA

Category: