Description

Reporting to the Billing Director, the primary function of the Biller is to generate accurate billing claims for insurance companies, as well as County, State, and Federal agencies for services rendered to clients in a medical setting. This role involves reviewing patient records, verifying insurance coverage, and ensuring that all claims comply with medical billing codes, regulations, and company policies. The Biller is responsible for submitting claims, following up on unpaid or denied claims, and resolving any billing discrepancies in a timely manner. Additionally, this position involves maintaining detailed records of all billing activities, preparing reports on billing trends and outcomes, and working closely with medical staff and insurance representatives to resolve any issues related to billing. The Biller ensures that all financial transactions are processed efficiently, contributing to the smooth financial operation of the medical facility.

• Performs daily medical chart review/work of billing.
• Ensures that all 3rd party billing is completed accurately and timely.
• Prepares, reviews and process claims on a daily basis.
• Reviews EOB’s and RTDS with outstanding corrected claims reprocessed in a timely manner as required by the payer.
• Responsible for the re-submission of claims for payment.
• Attends meetings and trainings as appropriate and assists in compiling reports as needed.
• Performs end of month reports and compiles aging reports.
• Fosters an environment that promotes trust and cooperation among all staff of STP.
• Enforces clinic policies and procedures to ensure that the principles of STP are implemented.
• Maintains confidentiality of all patient and employee information to all except designated employees.
• Informs Clinic Manager of matters of general interest and problem areas as such are determined or discovered.
• Ensures accurate documentation and timely submission of patient records for insurance reimbursement and compliance purposes.
• Coordinates with insurance companies to verify patient coverage and obtain necessary authorizations for treatments.
• Tracks and follows up on denied claims, working with patients and insurance providers to resolve issues and ensure payment.
• Attends all STP mandatory meetings and other meetings as requested.
• Adhere to HIPAA regulations and other relevant laws to protect patient privacy and confidentiality in all communications.
• Perform other duties as assigned by the executive leadership and administration.

Requirements

• High school diploma required
• Medical coding training or the equivalent
• Knowledge of CPT and ICD-10 coding, proper form usage.
• Basic computer literacy and arithmetic skills
• Medical billing certification
• Minimum 1 to 2 years medical billing
• ICD-10 coding proper form usage.
• High level of skill in maintaining calm, professional, courteous and helpful demeanor in times of pressure and stress.
• Skill in making appropriate decisions to benefit patients and meet company objectives.
• Ability to prioritize work and complete it on a timely basis with minimal supervision.
• Ability to follow procedures.
• Ability to deal with change and seek out opportunities to effect change to promote patient care.
• Strong customer service approach to problem solving situations.
• Ability to read, write, understand and spell English and Spanish correctly.

Language Requirements

• Spanish speaking, required.