Insurance Biller I

2 weeks ago


Escondido, California, United States Neighborhood Healthcare Full time
Job Summary

We are seeking a highly skilled and detail-oriented Insurance Biller I to join our team at Neighborhood Healthcare. As a key member of our billing department, you will play a critical role in ensuring the accuracy and efficiency of our medical billing processes.

Key Responsibilities
  • Validate correct coding processes to ensure compliance with Neighborhood Healthcare, contracts, funding programs, and agencies.
  • Review and obtain required information for missing and incomplete billings, including missing DX, procedure codes, payer specific needs, eligibility screening, and coverage verification.
  • Create and submit claims for clean billable charges and statements in compliance with correct coding initiatives and billing industry requirements.
  • Process and monitor system claim status categories to ensure all transactions are captured for month end close.
  • Register patients in the payment portal, as needed.
  • Review, process, and obtain patient eligibility information to ensure accuracy and completion, including acquisition of authorization numbers, as needed.
  • Apply discounts to billing statements for patients eligible for the Sliding Fee Discount Program (SFDP), as needed.
  • Post patient and insurance payments to account balance adjustments and write offs, as assigned.
  • Review and process refunds and insurance recoupment requests.
  • Submit patient statements on cash accounts, as needed.
  • Process monthly collection accounts for collection agencies, as needed.
  • Support the patient billing phone lines and voicemails; return calls, as needed.
  • Discuss billing inquiries with patients to resolve account questions and/or problems.
  • Negotiate payment plans with patients, as needed.
  • Provide excellent customer service to patients and escalate issues to a supervisor, if needed.
  • Respond to site, insurance, and patient correspondences related to billing in a timely manner.
  • Attend billing training and team meetings.
Requirements
  • High school diploma/GED required.
  • Medical billing or coding Certification from an accredited school preferred.
  • Two years of front office or medical administration experience required; medical billing experience preferred.
  • Experience working in a specialty and/or FQHC community clinic is preferred.
Preferred Qualifications
  • Excellent verbal and written communication skills, including superior composition, typing, and proofreading skills.
  • Ability to interpret a variety of instructions in written, oral, diagram, or schedule form.
  • Knowledgeable about and experience with insurance eligibility processes and coverage guidelines for multiple carriers.
  • Knowledgeable about and experience with billing compliance standards.
  • Knowledgeable on uses of CPT, HCPCS, and ICD codes.
  • Knowledgeable with insurance payers, funding sources, and managed care plans.
  • Ability to successfully manage multiple tasks simultaneously.
  • Excellent planning and organizational ability.
  • Ability to work as part of a team as well as independently.
  • Ability to work with highly confidential information in a professional and ethical manner.
Pay Range

$29.75 per hour, depending on experience.


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