Under direct supervision, the Insurance Biller is responsible for billing and collections activities, including reviewing and auditing codes, verifying insurance, posting charges and payments, and collecting monies from payors and/or patients.
Core responsibilities
- Post hospital and office charges and payments
- Review explanation of benefits to resolve accounts
- Review claim scrubber results and resolve claim edits
- Identify and resolve payer issues and patient billing complaints
- Maintain payer-related items such as EFTs and payer IDs for 835s
- Manage staff to ensure explanation of benefits are returned within 1 week of request
- Verify insurance eligibility and authorization
- Transmit electronic remittances and statements
- Work monthly aging for PPOs, Medicare, HMOs, cash, and Workers Compensation
- Run aging and month-end reports
- Document detailed notes and action items
- Respond to correspondence and inquiries from payers, patients, and other departments
- Perform collection actions with patients, insurance companies, and third-party payers
- Review denials from Medicare, PPOs, Workers Compensation, Commercial, and contracted carriers; correct and resubmit claims using ICD-9, ICD-10, and CPT codes
- Prepare write-off requests for denied claims that cannot be appealed
- Elevate issues to the supervisor as appropriate
- Participate in performance improvement initiatives
- Assist with orientation and training of new employees and volunteers
- Use basic computer programs
Requirements & Qualifications
Qualifications
- One year of biller/collection experience in a medical office or hospital
- Basic accounting skills
- Ability to use 10-key by touch
- Working knowledge of insurance verification, collections, claim edits, and denials management
- Familiarity with ICD-9, ICD-10, and CPT coding concepts
Location
California, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
1 week ago