Insurance Biller

Lexington Regional Health Center

Title: Insurance Biller

Date: June 26, 2024

Supervisor: Director of Financial Services

Department: Business Office

FLSA Status: Non-Exempt

Principle duties and responsibilities

1. Submits clean claims to make sure all edits are passed prior to sending claims to insurance companies.
2. Answers inquiries regarding applicable claims from patients and insurance companies.
   
3. Satisfies accounts after insurance companies pay for patient’s responsibility.
   
4. Assists with admissions, discharges, and transfers as needed.
   
5. Follows up on aged accounts until resolved with payors.
6. Calls patients or insurance companies for claim processing.
   
7. Appeals denials as appropriate with insurance companies.
   
8. Maintains the Business Office procedure book with updates as department processes change.
   
9. Registers patients and takes payments by check, cash or credit cards both in person and over the phone as needed.
10. Answers phone calls via the switchboard and routes them appropriately throughout the facility.
    
11. Ensures patients and visitors follow current infection control guidelines.
    
12. Responsible for ensuring the environment meets appropriate governing body standards.
    
13. Duties that could include blood exposure and risk to bloodborne pathogens (eg: lacerations, handling of blood-contaminated items, etc.)
    
14. Maintains patient and staff safety through the use of patient safety tools (Teamstepps, Just Culture, etc.).
    
15. Regular attendance at the assigned work location is required.
    
16. Performs other duties as assigned.

Minimum knowledge, skills, and abilities

1. Ability to read, write, basic accounting, and use standard office equipment and computer software as is typically acquired through the completion of a high school diploma or equivalent.
2. Individual must be 19 years of age in order to sign legal documents.
   
3. Ability to keep up on changes with federal and state rules and regulations.
   
4. Ability to maintain strict confidentiality with regard to protected and sensitive information.
   
5. Ability to solve problems independently and confidently by applying analytical and logical thinking.
   
6. Ability to read, analyze, and interpret reports, general business directives, policy and procedure statements, and governmental regulations.
   
7. Ability to complete reports and correspondence at a professional level.
   
8. Ability to immediately respond to common inquires and complaints from patients, employees, and regulatory agencies in collaboration with supervisor and administration.
   
9. Ability to effectively communicate with individuals from diverse backgrounds and varying educational levels.?
   
10. Ability to effectively organize and present information and respond to questions from employees and external groups of varying sizes.
11. Successful completion of required knowledge and training of standard precaution protocols and when to apply during principle duties and responsibilities.

Working conditions

1. Works in a normal office work environment with little exposure to excessive noise, dust, temperature, etc.
2. Spends significant amounts of time at a desk both writing and on a computer, 95% of work time. Requires fine motor coordination up to 70% of work time. Boxes weighing up to 36 pounds are filled with paper and are required to be filled and transported from floor to 36 inch countertop for storage. These boxes are then transported using a dolly cart approximately 250 feet. A 50 pound box of printer paper is required to be emptied from countertop to cupboard below, each ream of paper weighing 5 pounds.

Management responsibilities

1. None

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Job description statements are intended to describe the general nature and level of work being performed by employees assigned to this job title. They are not intended to be a complete list of all responsibilities, duties and skills required.