Medical Biller/Collector

4 days ago

Santa Rosa, California, United States Santa Rosa Community Health Full time
Job Summary

A Medical Biller/Collector is responsible for accurate and timely billing insurance plans, collection and posting of payments, all claims follow-up, billing of secondary claims, and posting patient charges as directed by Billing Supervisor.

The Medical Biller/Collector has knowledge of all aspects of billing insurance plans, Medi-Cal, Medicare and special aid programs, and patient collections.

Key Responsibilities
  • Inputs charges for private pay, insurance, Medi-Cal, Medicare and special aid programs into the practice management system.
  • Sees to completion of charges regarding DX & procedures.
  • Process and submits primary claims electronically.
  • Submits patient statements 2-3 times a week.
  • Copies and submits paper claims.
  • Able to answer billing, insurance, and aid program questions and understands account balances.
  • Makes calls to insurance companies regarding proper address of claims and eligibility as needed.
  • Assists in daily collection of patient balances.
  • May handle daily cash, balance to a daily journal.
  • Audits and corrects demographics as needed.
  • Makes calls to and receives calls from patients as needed regarding billing and statement questions.
  • Applies patient payments, insurance payments and copays as instructed.
  • Audits and corrects demographics as needed.
  • Maintains an up-to-date billing manual for reference and/or is familiar with where to locate information on the internet.
  • Call insurance carriers to check status of claims.
  • Accurately uses ICD10, CPT, and HCPCS coding.
  • Keeps Accounts Receivable to 45 days by working Aging and timely follow-up of unpaid claims and working claim denials.
  • Identifies and resolves billing and claim queries/problems.
  • Performs any work as described above in an independent, responsible manner.
  • Participates in ongoing training.
  • Other duties as assigned.
Requirements
  • High school diploma or equivalent.
  • Experience with eCW preferred.
  • Insurance billing experience preferred.
  • Knowledge of medical billing and collections terminology.
  • Must take initiative and work in an independent fashion.
  • Ability to perform diversified clerical functions and basic accounting procedures.
  • Ability to effectively communicate with people at all levels and from various backgrounds.
  • Commitment to excellence and high standards.
  • Strong organizational, problem-solving, and analytical skills.
  • Acute attention to detail.
  • Versatility, flexibility, and a willingness to work within constantly changing priorities with enthusiasm.
  • Knowledge of claim follow-up for Medicare, Medi-Cal, CDP, Family Pact, private insurance, CHDP and more.
  • Ability to make status calls to facilitate claim payment.
  • Ability to make calls to patient to facilitate payment plans on aged accounts.
  • Able to meet aggressive collection goals.
  • Ability to successfully handle claim denials.
  • Demonstrated outstanding customer service.
  • Ability to work independently and as a member of the collections team.
  • Fluency in English and Spanish (speak, read and write) preferred.
  • Ability to work a flexible schedule.
  • Demonstrates knowledge of compliance issues within the community clinic environment.
  • Demonstrates a willingness to report any incident that is unusual or incompatible with accepted clinic procedures.
  • Always maintains confidentiality of patients by complying with HIPAA policies.
  • Strong interpersonal skills; ability to be sensitive with persons of various social, cultural, economic, and educational backgrounds.
  • Proficiency with Microsoft Office applications including Outlook, Word, Excel and PowerPoint.
  • Strong organizational skills with ability to prioritize projects, work relatively independently, manage multiple tasks, and meet deadlines.
  • Strong written and verbal communication skills.
  • Good judgment, problem solving and decision-making skills.

SRCH provides reasonable accommodation for individuals with a physical or mental disability to apply for jobs and to perform the essential functions of their jobs unless it would cause an undue hardship.

SRCH is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding, and related medical conditions), and sexual orientation.

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