Revenue Cycle Biller Iii

4 weeks ago

Phoenix, United States 10 - RI International Full time

**RI International is the leader in Peer-Powered Support to those in crisis for mental health and substance use.**

Our **Mission** is to empower people to recover, succeed in accomplishing their goals, find meaning and purpose in life, and reconnect with themselves and others.

Our **Vision **is to activate the next generation of frame-breaking healthcare innovation to support people beyond their behavioral health needs and succeed in the community where they live, work, and play.

**Job Type**

Full-Time: Non-Exempt

**Shift**

Day

**Shift Hours**

8:00am to 5:00pm Monday-Friday

**Specialties / Licenses or Certifications**

N/A

**Work Setting**

Remote

**Salary/Hourly Wage**

$28.00 - $30.00/hour

**Our Position**

The Revenue Cycle Biller III position is responsible for providing claim processing, data entry and administrative support functions for the organization's Billing Department.

**Your Responsibilities**
- Experienced in end-to-end Revenue Cycle Management activities which includes initial claims submissions to primary, secondary, and tertiary funders, claims editing and scrubbing, and identifying the proper coding guidelines.
- Run reports from the practice management system daily to capture all charges to bill funders in a timely manner.
- Review rejections per funder upon processing of the CSV/835 file and follow up in the practice management system to fix errors for claims initial and resubmissions.
- Analyze electronic files, review, and update replacement codes and make the necessary corrections for accuracy per initial billing.
- Train, mentor, and educate new hires and monitor workflow on a daily basis for all states
- Identify and research rejections and follow up into the practice management system to ensure clean claims for initial submission of all claims.
- Ability to follow up on rejection via payer portals, edit, modify, and correct errors in the Practice Management system during your daily tasks
- Expert knowledge of Medicare, Medicaid, Third Party regulations and billing guidelines for claims submissions
- Follow-ups on claim rebills both electronically and manually, as needed, and uses all technology available to produce clean claims rate.
- Performs special resubmissions for projects, claims corrections by utilizing the appropriate claims codes per the funder guidelines.
- Review claims that are not set up electronically to ensure the correct payer ID# is added in the system.
- Interprets claims processing reports and applies information to produce clean claims.
- Make changes to the clients' demographics, make modifications to correct the funders' claims address, CPT, HCPCS, and ICD-10 codes as necessary to process clean claims.
- Must have the ability to analyze coding and diagnoses to assure proper billing of claims to funders.
- Requests and attaches required clinical documentation in accordance with third party requirements.
- Tracks all claims upon submission per funder and reports the data via Excel and saves it on SharePoint daily.
- Prioritizes work to maximize turnaround time and have a proven track record for improving process efficiencies and solving problems.
- Refer to the billing process to submit claims to all funders per state requirements.
- Understands and adheres to RI International compliance standards as they appear in the Code of Conduct and Conflict of Interest Policies.
- Performs other related duties as assigned.

**Our Requirements**
- High school diploma or equivalent.
- 5+ years of medical billing experience.
- Working knowledge of CMS guidelines, contracted insurance guidelines and coding policies.
- Demonstrated computer skills.
- Detailed oriented, reliable, and able to multi-task in a fast-paced, high-volume work environment.
- Intermediate to Advanced proficiency in Microsoft Excel.
- Ability to maintain a high level of confidentiality (HIPAA guidelines and regulations) and professionalism.
- Must have a valid driver license and be 18 years of age.
- Must have the ability to walk, climb, stoop, reach, crawl, crouch, kneel, push, pull and lift a minimum of 10lbs.
- Must have excellent written and verbal communication, with particular emphasis during telephone calls, follow-ups, and in-person correspondence.
- We are a Second-Chance Employer
- Must be able to pass a seven-year background check.
- Must be able to pass substance abuse testing and/or tuberculous testing (if applicable).
- Must be able to pass an education verification check.
- Must be able to pass a three-year motor vehicle report and meet minimum eligibility requirements criteria of insurance carrier (if driving is required for this position).

**Associated Knowledge, Skills, and Abilities**
- Above average computer skills including databases, spreadsheets, interface file maintenance and related computer programs designed for billing, coding, and accounting purposes.
- Ability to focus on the big picture while attending to multiple detail requirements in a changing environment

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