BILLER I

Job Details
Full-timeEstimated: $37,000 – $53,000 a year1 hour ago
Qualifications
  • Communication skills
  • Computer skills
Full Job Description
JOB SUMMARY

Job Class: Biller I-II-III-IV

Department: 9630- Patient Accounts / 9630- Clinic Management

CORE DUTIES AND RESPONSIBILITIES

Demonstrates Competency in the Following Areas:GENERAL FUNCTION:
This training position is accountable for learning how to process all commercial insurance claims accurately and timely on 1500 and UB04 forms. Commercial insurance claims include: Blue Cross, Workmen’s Comp, HMO & PPO insurances, Champus, Contractual policies, etc… Timely follow-ups on claims to ensure payments are received.

JOB DUTIES:

  • Maintain established policies and procedures, objectives, quality assurance program and safety standards.
  • Research all information to complete billing process.
  • Accurate filing of all claims.
  • Answer any inquiries regarding billing of accounts.
  • Maintain department records, reports, and files as required.
  • Participate in educational programs and in-service meetings.
  • Perform other job duties as assigned or requested.

MINIMUM QUALIFICATIONS:

  • Must be able to type 30 wpm with computer skills
  • Must be able to read and write and have good communication skills
  • Billing experience preferred

TRAINING TIERS

A Biller I is considered a trainee. A trainee has three (3) months in which to demonstrate competency on three (3) of the following skills. Should the trainee not meet this goal, they may be transferred to a lesser position, retrained or terminated

Create Encounter

Key Changes

Verify Insurance

Release Charges

Correct Rejections

Answer Phones

A Biller I/Trainee has six (6) months in which to demonstrate competency in all of the above areas. Once demonstrated, trainee will be moved to a Biller II. Should the trainee not meet this goal, they may be transferred to a lesser position or terminated.

A Biller II has six (6) months from becoming a Biller II to demonstrate competency in three (3) of the following skills:

AR Follow Up

Work Denials

Review Claims and make necessary corrections

Follow up on insurance

Make Corrections

The Biller II will be moved to a Biller III. Should the Biller II not meet this goal, they may be transferred to a lesser position or terminated.

A Biller III has six months from becoming a Biller III to demonstrated competency in all areas listed for the Biller II. A Biller III will be moved to a Biller IV when all areas are mastered.

CONTACTS:

  • Within organization—all departments
  • Outside organization—insurance companies, doctor offices, nursing homes, patient employers, vocational rehabilitation, and welfare department.

DECISION MAKING:

  • Decision taken to supervisor for approval:

ETO Time

Clarification of changes of a procedure

Location: South Central Health System · CLINIC MANAGEMENT SERVICES

Schedule: Full Time, Days

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