Medical Biller

We are seeking a skilled Medical Biller to join our team at Guidehouse. As a Medical Biller, you will play a critical role in ensuring the accurate and timely processing of healthcare claims.

• Perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims.
• Work with other departments to facilitate the meeting of both departmental and facility goals and objectives.
• Demonstrate an ability to find solutions to problems and keep management informed of patterns regarding billing edits, compliance issues, payments, and other issues with specific payers.
• Perform daily download and reconciliation of claims from patient accounting system to electronic billing system.
• Transmit or release claims at a minimum daily.
• Work all assigned claims daily by resolving edits, validating claim, or placing on departmental hold by reason.
• Follow-up on all assigned held claims or unreleased claims.
• Bills claims via electronic billing system.
• Reviews same day and 72 hour admission report to determine if accounts needed to be combined.
• Ensures all address changes and or plan changes are forwarded to the appropriate people so the integrity of the insurance master is maintained.
• Files adjusted billings based on audits and or changes in diagnosis or DRG.
• Updates patient accounts with corrected demographic or insurance information.
• Works all rejection and payer audit reports within 48 hours of receipt taking whatever action may be required to obtain account resolution.
• Monitors all denials for trends and issues and reports finding to supervisor.
• Bills or re-bills as necessary.
• Ensures hospital is in compliance with all state and federal rules and regulations both billing and HIPAA.
• Assigned special projects will be completed within the time frames given.
• Appropriately documents electronic billing system and/or patient accounting system.
• Attends training sessions and seminars offered by the Hospital and Third Party Payers.
• Handles all customer calls both internal and external in a professional and courteous manner.
• Returns calls and emails as soon as possible, but must be returned within 24 hours.
• Follows the mission statement and values established by the facility.

• High School Diploma / GED or 3 years of relevant equivalent experience in lieu of diploma / GED.
• 0-2+ years working within the following sectors: healthcare, insurance, business, finance or customer service.
• Working knowledge can be of the following: insurance claims, billing, coding, follow-up, finance, accounting or customer service related responsibilities.

• Previous billing background.
• Emphasis in Hospital Billing.
• Excellent communication and interpersonal skills.
• Experience with Excel and Word.

Guidehouse is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.