The accounts receivable biller is in charge of calculating and collecting payments for medical procedures and services provided by the facility. This position will submit claims to insurance companies from a wide variety of medical providers and facilities, as well as monitoring and ensuring payments are received in a timely manner. Their work includes updating patient data, developing payment plans, preparing invoices and acting as an intermediary between healthcare providers, clients, patients and health insurance companies. The accounts receivable biller will work under the general supervision of the department supervisor.
MINIMUM QUALIFICATION STANDARDS:
Education: High School Diploma or GED.
Licensure/Certification: Certified Medical Biller, preferred.
Work Experience: 1-2 years in a medical office setting, preferred.
Freedom from illegal use of drugs, and freedom from use and effects of use of drugs and alcohol in the workplace.
Persons who have been found guilty by a court of law of abusing, neglecting or mistreating individuals in a health care related setting are ineligible for employment in this position.
SKILLS AND KNOWLEDGE REQUIREMENTS:
Must possess a team-oriented attitude and adhere to a continued willingness to implement new systems of operation when changes are required to promote patient and facility health, safety and satisfaction.
Ability to work independently and manage multiple projects and activities simultaneously. Must be able to prioritize projects and handle change productively when assigned additional tasks/projects.
Conduct self in a professional, courteous manner with co-workers, staff and the public in order to maintain a cooperative relationship among the healthcare teams. Must adhere to a philosophy and culture of teamwork and cooperation at all times.
Must have excellent oral, written, and interpersonal communications skills, as well as a high level of sophistication to effectively communicate and interact with customers, co-workers, supervisors and the public.
Attend and participate all in monthly staff meetings and assigned training.
ESSENTIAL JOB FUNCTIONS:
Prepare and review patient bills for accuracy and completeness; submit billing data and medical claims to insurance companies; process claims as they are paid and credit accounts accordingly.
Follow-up on accounts with missed payments or late payments. Assist customers with setting up payment plans. Promote the facilities assistive payment programs to help customers meet financial commitments.
Identify insurance company or proper party (patient) to be billed; identify and bill secondary or tertiary insurances.
Review insurance payments for accuracy and compliance with contract discounts; work on denial of claims to ensure maximum reimbursement for services provided.
Communicate with health care providers, patients, insurance claim representatives and other parties to clarify billing issues and facilitate timely payment. Consult with supervisor, team members and appropriate resources to solve billing questions, when needed.
Utilize a combination of electronic health record (E.H.R.) and paper patient records to perform billing duties; maintain an accurate, legally compliant medical record.
Maintain work operations and quality by following standards, policies, and procedures; escalate issues to supervisor.
Prepare reports and forms as directed and in accordance with policies.
Perform a variety of administrative duties, including but not limited to: answering phones; faxing and filing of confidential documents; and basic internet and email utilization.
Able to carry out the essential functions of this job (with or without reasonable accommodation) without posing specific, current risk of substantial harm to health and safety of self and others.
NOTE: The essential functions are intended to describe the general content of and requirements for this position. They are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be outlined by the incumbent’s immediate manager and may change dependent on the need of the department.
PHYSICAL, PSYCHOLOGICAL AND ERGONOMIC REQUIREMENTS: