Certified Medical Biller

GENERAL SUMMARY OF DUTIES: Responsible for gathering charge information, coding, entering into data base complete billing process and distributing billing information. Responsible for processing and filing insurance claims and assists patients in completing insurance forms.

LOCATION: Business Office

SUPERVISON RECEIVED: Reports to Accounts Receivable Manager.

SUPERVISION EXERCISED: None.

FLSA STATUS: Non-exempt.

ESSENTIAL FUNCTIONS:

1. Researches all information needed to complete billing process including getting charge information from physicians.

2. Codes information about procedures performed and diagnosis on charge.

3. Assists in the processing of insurance claims including Medicaid/Medicare claims.

4. Processes all insurance provider’s correspondence, signature, and insurance forms.

5. Assists patients in completing all necessary forms, to include payment arrangements made with patients. Answers patient questions and concerns.

6. Keys charge information into entry program and produces billing.

7. Processes and distributes copies of billings according to clinic policies.

8. Follows-up with insurance companies and ensures claims are paid/processed.

9. Resubmits insurance claims that have received no response or are not on file.

10. Works with other staff to follow-up on accounts until zero balance.

11. Assists error resolution.

12. Maintains required billing records, reports, files.

13. Research return mail.

14. Answers telephone, screens calls, takes messages, and provides information.

15. Participate in regularly scheduled, routine coverage of the Financial Office to assist visiting patients.

16. Participates in educational activities.

17. Maintains strictest confidentiality.

18. Other duties as assigned.

The job holder must demonstrate current competencies applicable to the job position.

EDUCATION: High school graduation or GED.

EXPEREINCE: Minimum of one year billing experience in health care organization.

REQUIREMENTS: None.

KNOWLEDGE:

1. Knowledge of billing practices and clinic policies and procedures.
2. Knowledge of coding and clinic operating policies.
3. Knowledge of medical terminology.
4. Knowledge of insurance industry.
5. Knowledge of grammar, spelling, and punctuation to type correspondence.

SKILLS:

1. Skill in computer programs, spreadsheets and applications.
2. Skill in using a calculator.
3. Skill in typing 40 wpm.

ABILITIES:

1. Ability to understand and interpret policies and regulations.
2. Ability to prepare documents in response to complaints and inquiries.
3. Ability to examine documents for accuracy and completeness.
4. Ability to read, understand, and follow oral and written instruction.
5. Ability to sort and file materials correctly by alphabetical or numeric system.
6. Ability to communicate effectively and work with others.

ENVIRONMENTAL / WORKING CONDITIONS: Work is performed in an office environment. Involves frequent contact with staff, patients, and the public. Work may be stressful at times. Contact may involve dealing with angry or upset people.

PHYSICAL/MENTAL DEMANDS: Work may require hand dexterity for office machine operation, stooping and bending to files and supplies, mobility to complete errands or deliveries, or sitting for extended periods of time. Manual dexterity for using a calculator or computer keyboard.

This job description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve. This job description is not to be construed as a contract for employment.