Hours: 9:00 a.m. - 5:30 p.m. M-F

Location: Administration Building

JOB DUTIES:

The Medical Biller position is responsible for performing diverse medical billing duties in a timely manner as well as Accounts Receivables. The position includes assisting with the planning, management and direction of Accounts Receivable and Billing, calling on various Third Party payors and follow-up on all edits, payments and adjustments to patient accounts. Act as liaison to patients and payors handling day-to-day transactions and cash receipts. Review, and reconcile claims, super-bills, patient statements, patient accounts and payor activities. Assist in developing short and long-term strategic operational goals for the department. Prepares daily, weekly, monthly activity, and cost savings reports. Additionally:

  • Working knowledge of ICD9, HCPCS & CPT coding, and Third Party billing
  • Knowledge of account collections, and month end closing procedures
  • Ability to work on the weekends and evenings
  • Familiar with Physician Credentialing process
  • Experience with Managed Care Organization (MCO) contracts
  • Knowledge of advanced medical terminology
  • Familiar with in-patient, ambulatory coding, procedures, and electronic billing systems
  • Ability to recognize and challenge improper or inaccurate coding
  • Demonstrate excellent communication skills, both written and verbal
  • Demonstrate outstanding organizational and problem-solving skills with acuity for systemic thinking
  • Ability to work independently and effectively organizes complex work processes
  • Knowledge of Medicare/Medicaid insurance claims, corrections and HMO billing protocols
  • Review and reconcile claims, super-bills, patient statements, patient accounts and payors
  • Responsible for documentation of payments, maintaining patient payment records, letter drafting, billing and collection calls
  • Prepare daily, weekly, monthly activity, and cost savings reports (Aging, Unapplied Cash, CPT Frequency, Billing Errors, Unpaid Claims, etc.), including posting charges, payments and follow-ups
  • Participate and assist in maintaining that The Wellness Plan is in compliance with privacy and security regulatory requirements of the federal Health Insurance Portability and Accountability Act (HIPAA)
  • Perform other duties as needed and/or assigned

MINIMAL REQUIREMENTS:

Formal education required: High school diploma, with 3-years’ experience in a third-party billing and collections environment, certification in medical billing and coding and a minimum of 3-years patient receivables, medical billing, and claims processing.

Further formal education which is not required but which may be desirable: Associates Degree in Accounting, Business or related discipline. Bachelor’s Degree. LBSW certification from State of Michigan Although not required, but preferred:

Additional knowledge, skills and abilities which are not required but which may be desirable: Experience working in a federally qualified health center or community health center. Experience working in a FQHC.

Computer Skills: Word, Outlook, Excel, PowerPoint and web navigation skills.