The Medical Biller is responsible for collecting, posting and managing account payments. He/she is also responsible for coding and entering charges, submitting claims and following up with insurance companies for multiple physicians.
ESSENTIAL JOB FUNCTIONS
· Prepares and submits claims to various insurance companies either electronically or by paper
· Enters patient demographics into billing software
· Answers questions from patients, clerical staff, accountants and insurance companies
· Identifies and resolves patient billing complaints
· Prepares, reviews and sends patient statements
· Evaluates patient’s financial status and establishes budget payment plans. Follows and reports status of delinquent accounts
· Reviews accounts for possible assignment and makes recommendations to the Billing Manager and Executive Director; prepares information for the collection agency (when applicable)
· Performs daily backups on office computer system
· Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers
· Processes payments from patients and insurance companies
· Participates in educational activities and attends monthly staff meetings, or more frequently as required.
· Conducts themselves in accordance with Practice’s employee manual
· Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations
· Run billing and collection activity reports as required by Billing Manager or Executive Director
QUALIFICATION REQUIREMENTS
· Proficiency in medical billing/collection practices
· Proficient in using computers
· Prior experience using Medical Billing software and Microsoft Word and Excel
· Knowledge of medical coding and third-party operating procedures and practices. Intermediate level understanding of ICD 10 and CPT medical billing codes and medical terminology
· Ability to operate a computer and basic office equipment (copier and fax machine)
· Ability to operate a multi-line telephone system
· Skill in answering a telephone in a pleasant and helpful manner
· Ability to establish and maintain effective working relationships with patients, employees and the public
· Must be well organized and detail-oriented
· Must be able to utilize analytical and problem solving skills
EDUCATION and EXPERIENCE
· Associates Degree or higher preferred
· Three to five years’ experience in medical billing
· Experience in EPIC is strongly preferred
· Proficient knowledge of medical terminology
LANGUAGE SKILLS
· Fluent in English
CERTIFICATES, LICENSES, REGISTRATIONS
· Must have current valid Michigan driver’s license
· Must have valid automobile insurance and reliable transportation or alternative provisions
OTHER SKILLS AND ABILITIES
· Maintains confidentiality of organizational and patient records
· Basic computer skills are required
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
· Performs duties in office environment during organization’s operating hours
· Requires ability to handle stressful situations with calmness and courtesy at all times
· Sits, stands, bends, lifts files and moves intermittently during work hour
· Subject to frequent interruptions
· Involved with patients, family members, personnel, visitors, etc.
· Communicates with physicians, nursing personnel, medical assistants, office staff and other department supervisors
· Attends and participates in continuing education programs as required