“Providing the highest quality medical care to our patients

in a professional setting that is comfortable, efficient, and cost effective.”

JOB DESCRIPTION

JOB TITLE:Biller, Insurance Processor

REPORTS TO:Billing Department Supervisor

STATUS:Non-Exempt, HourlySalary

POSITION SUMMARY

This position is responsible for day-to-day accounts receivable.

ESSENTIAL JOB FUNCTIONS

  1. Stays current on all changes, additions, deletions to coding rules, proper usage of modifiers, CPT codes, HCPCS codes, etc. especially with regards to ASC guidelines.
  1. Posts previous day’s cases once coded. Verifies patient demographics are correct and that all proper authorizations are in place prior to sending claims.
  1. Posts insurance payments to proper patient accounts the following business day from the date of deposit.
  1. Posts all payments, applies proper contract allowances and follows up on all denials and claims paid incorrectly.
  1. Stays current on all facility contracts, making sure contracts are being followed as well as the billing procedures of the facility are being performed correctly.
  2. Communicates with others as needed and assists with education of others with regards to billing procedures, insurance changes, updates, etc.
  1. Assists in the updates of facility fee schedules and insurance contracts in AR system.
  1. Works assigned A/R on a weekly basis, making sure all billed charges have been received by the payer and is in process. Catches problem claims early and helps to resolve any issues to insure a timely payment will be achieved.
  1. Reconciles accounts with credit balances, completing necessary documentation to verify refund is needed and takes to management for refund approval and processing within company and payer policies.
  1. Works assigned patient accounts on a weekly basis.
  1. Prepares weekly AR reports for Collection and AR meeting.
  1. Works with Collection Agency with accounts in collections.
  1. Maintains Billing Manual for their position.
  1. Cross-trains with others to help provide adequate coverage when needed.

OTHER JOB FUNCTIONS

  1. Attends staff meetings, in-services, trainings,conferences, or other company events as requested.
  1. Performs other duties as assigned.

QUALIFICATIONS

Education, License, and Experience

  • High school diploma or equivalent. Post secondary education preferred.
  • Two or more years experience working in a billing department.
  • Ability to perform 10-key by touch highly preferred.

Knowledge, Skills and Abilities

  • Knowledge of medical billing processes and procedures.
  • Strongmathematical skills: ability to accurately work with numbers.
  • Ability to work effectively with physicians and their offices, employees, patients, and third party payer customer service representatives.
  • Excellent verbal and written communication skills; ability to clearly communicate with others.
  • Proficient with computers and Microsoft Office products: Word, Excel, Outlook, etc.
  • Organized with ability to effectively handle multiple deadlines.
  • Ability to provide dependable, on-time attendance.

GENERAL PHYSICAL REQUIREMENTS

Most of work is performed in a medical office setting shared by others. May require sitting for long periods of time. Position requires hand manipulative skills for word processing and writing. Must be able to hear verbal conversations over the phone and in-person with background noise. Must be able to consistently identify objects and persons at a distance and read fine print on computer and various forms.Minimal patient interaction with no exposure to blood and/or other body fluids.

The statements contained herein reflect general details as necessary to describe the principal functions of this job, the level of knowledge and skill typically required and the scope of responsibility, but should not be considered an all-inclusive listing of work requirements. Individuals may perform other duties as assigned including work in other functional areas to cover absences or relief, to equalize peak work periods or otherwise to balance the workload. Furthermore, they do not establish a contract for employment and are subject to change at the discretion of the employer.

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Employee Signature:Print Name:Date:

Reviewed: March 2016Page 1