JOB SUMMARY: The Biller is responsible for submitting claims to the appropriate intermediaries and to insure that procedures and charges are coded in compliance with all payers including Medi-Cal and/or Medicare regulations.
Responsible for obtaining required authorizations necessary for the processing and payment of claims. The Biller is responsible for the follow-up and denial management as necessary for final resolution. Responsible to identify the various types of diagnosis and procedures codes (ICD9, CPT, HCPCS, DRG) as they relate to reimbursement.
Communicates clearly and efficiently by phone and in person with clients and staff members. Maintains productivity standards and reports. Obtains updated demographic information and all necessary information needed to comply with the various Government Programs billing requirements.
Operates computer to input follow up notes and retrieve collection and patient information. Maintains proficiency in Medical Terminology
EDUCATION, EXPERIENCE, TRAINING
1.Previous Billing Experience within a hospital Business Office Required.
2.Previous experience with government programs and collections preferred.
3.Knowledge of medical terminology
4.Effective written and verbal communication skills
5.Ability to multi-task, prioritize needs to meet required timelines
6.Analytical and problem-solving skills
7.Customer Services experience required
8.High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires)
Work Type: Full Time Employee
Legend: Shift 1=Day, 2=Evening, 3=Night, 4=Varied.
We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation, or other protected characteristics. If you need special accommodation for the application process, please contact the Human Resources Department.
EEO is the law poster.
Prime Healthcare Systems