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