Insurance Biller Collector

Role Description

As an Insurance Biller, you will provide critical support in the revenue cycle, meticulously processing and submitting claims to ensure timely and accurate reimbursement for services rendered. Every day you will expertly review patient accounts, verify insurance information, apply correct coding, and meticulously prepare and transmit claims, diligently following up on rejections and denials to maximize revenue capture. To be successful, you will demonstrate outstanding attention to detail, strong knowledge of billing regulations, and a persistent, analytical demeanor, contributing significantly to the financial health of the organization.

Qualifications

• Two (2) years Hospital billing/collection experience or other related healthcare provider claims experience in a high volume medical healthcare claim environment.
• AHCCCS/Medicare/government Commercial payer experience.
• UB-04 billing experience.
• High School Graduate or Diploma.
• Previous experience with computerized billing systems, Word Processing and Spreadsheet applications.

Requirements

• Performs daily billing functions for assigned Accounts Receivable claims to ensure claims resolutions within set deadlines.
• Responsible for resolution of accounts.
• Maintains average QA percentage at a rate established for the Fiscal Year goal.
• Performs follow up on any outstanding accounts and obtains commitment for payment from insurance carrier.
• Maintain productivity percentage at a rate established for the Fiscal Year goal.
• Sends out daily appeals to insurance companies for denied claims to maintain consistent cash flow of assigned A/R.
• All denied accounts to be worked via Cerner and have accurate action taken assigned for completion.
• Resolves incoming correspondence or telephone inquiries in a timely manner in accordance with payer deadlines.
• Identifies trends and patterns in claims processing and participates in process improvement.
• Documents on system all actions taken on account so that it clearly communicates action taken.
• Demonstrates knowledge and use of Cerner, the Billing clearing house, and other related PFS software.
• Displays competency in the use of departmental equipment; e.g., telephone system, computers, facsimile, copy machine, timekeeping technology, etc.
• Performs routine assignments independently, consistently prioritizes workload, offers assistance to co-workers, and seeks help when necessary.
• Reports problems, questions or suggestions to immediate supervisor.
• Consistently follows departmental chain of command.
• Defuses potential problems or conflicts by handling situations, referring to Supervisor/Manager/Director, or following departmental policies.
• Maintains current knowledge regarding area of expertise.
• Keeps up to date on billing changes (UB-04/HIPPA) as related to assigned payers.
• Attends PFS departmental meetings.

Benefits

• Four (4) years Hospital billing/collection experience or other related healthcare provider claims experience in a high volume medical healthcare claim remote environment.
• College level business courses.
• Two years relevant college education and experience.
• Experience with Google Workplace applications, Billing clearing house and Cerner.