Medical Biller Job in Murrieta, California

GENERAL SUMMARY OF DUTIES: Responsible for working with the physicians and office staff to ensure that all office visits, consults and surgeries are billed in an appropriately and in a timely manner, aggressively manages AR, Follows up on claims payments/status and assists patients to answer any billing related questions or concerns

LOCATION: Murrieta                  

SUPERVISON RECEIVED: Practice Manager and Office Manager.       

SUPERVISION EXERCISED:  None

Hours: Monday- Thursday 7:30am-5:00Pm and Friday: 7:30am- 1:00PM                                      

Overtime Status:       Non-exempt.

ESSENTIAL FUNCTIONS:

1.                  Researches all information needed to complete billing process, includes obtaining charge information from physicians.

2.                  Reviews Operative notes and compares to codes provided by physician for accuracy, obtains information about procedures performed and diagnosis information and uses coding expertise to correct or modify codes when necessary.

3.                  Electronically submits Surgical claims and E&M claims to clearing house for processing by insurance company

4.                  Processes all insurance provider’s correspondence, signature, and insurance forms.

5.                  Assists patients in completing payment arrangements. Skillfully answers patients’ questions and concerns.

6.                  Keys charge information into entry program and produces billing.

7.                  Conducts, recommends, and educates on all coding of services rendered

8.                  Follows-up with insurance companies and ensures claims are correctly paid/processed per insurance fee schedules.

9.                  Resubmits insurance claims that have received no response or are not on file.

10.              Works with other staff to follow-up on accounts until zero balance.

11.              Assists error resolution.

12.              Maintains required billing records, reports, files.

13.              Identifies, initiates, implements and manages business practices, policies, processes and goals

14.              Proficient organizational skills, attention to detail and accuracy

15.              Ability to exercise initiative, problem-solving and decision making

16.              Excellent interpersonal and communication skills.

17.              Must be a team player

18.              Demonstrates customer service-oriented attitude/behavior

19.              Participates in educational activities and out of town educational conferences.

20.              Maintains strictest confidentiality, HIPAA compliance

21.              Other duties as assigned. 

SCOPE:

A.        Operates within financial policies, procedures and budget with effective use of resources

B.        Ensures compliance in federal, state and other regulations including corporate, compliance, licensure, safety and security as relates to general office operations 

The job holder must demonstrate current competencies applicable to the job position.

EDUCATION/ CERTIFICATION:          

High school graduation or GED.

Certified Biller

Prefer -Certified Professional Coder Certification through a Professional Coding Program, such as AAPC (American Academy of Professional Coders) or AHIMA (American Health Information Management Association)

EXPERIENCE:        Billing and Coding experience- 3 years +

                                    Neurosurgery experience preferred

KNOWLEDGE:      

1. Knowledge of billing practices and clinic policies and procedures.
2. Knowledge of coding and clinic operating policies.
3. Knowledge of medical terminology.
4. Knowledge of various insurance payer’s including their policies and procedures
5. Knowledge of grammar, spelling, and punctuation to type correspondence.
6. Knowledge of accounting principles as they apply to A/R

SKILLS:

1. Skill in computer programs, spreadsheets and applications.
2. Skill in using a calculator.
3. Skill in typing 40 wpm.
4. Skill in A/R management principles              

ABILITIES:

1. Ability to understand and interpret policies and regulations.
2. Ability to prepare documents in response to complaints and inquiries.
3. Ability to examine documents for accuracy and completeness.
4. Ability to read, understand, and follow oral and written instruction.
5. Ability to sort and file materials correctly by alphabetical or numeric system.
6. Ability to communicate effectively and work with others.

ENVIRONMENTAL / WORKING CONDITIONS: Work is performed in an office environment. Involves frequent contact with physicians, staff, patients and insurance companies. Work may be stressful at times. Contact may involve dealing with irate people.

 PHYSICAL/MENTAL DEMANDS: Work may require hand dexterity for office machine operation, stooping and bending to files and supplies, mobility to complete errands or deliveries, or sitting for extended periods of time. Manual dexterity for using a calculator or computer keyboard.