Job Title: Billing & Payroll Specialist
Hours: Monday – Friday, 8:30 am to 5:00 pm
Job Type: Full-time
Reports to: Billing & Payroll Manager
Job Description: The medical biller is responsible for the timely submission of medical claims to insurance companies. Medical billing is very detailed oriented and requires a lot of attention. The medical biller needs to understand how to read medical records such as, the diagnosis code. He/she should be familiar with HCPCS Level II and ICD-10-CM codes. Also, the medical biller should understand how prior authorization and NPI numbers work. Medical billing consists of translating a healthcare service into a medical billing claim. The responsibility of the medical biller at T&N Reliable Nursing Care is to bill claims, follow the claims to ensure the practice receives proper reimbursement for the work the providers perform.
Job Responsibilities:
The essential functions for the Medical Biller include the following:
Prepares and submits patient claims to appropriate third party payers
Reviews claims to ensure that payer specific billing requirements are met
Resolves routine and non-routine patient billing inquiries and problems
Collects patient documentation for claim submission
Ensures claim forms are completely and accurately filled-out
Updates and maintains patient billing data and ensures documents are current
Follow up on unpaid claims within standard billing cycle timeframe
Contacts clinical staff for clarification on procedures or diagnosis and on missing information
Updates billing software with rate changes and other appropriate information
Follow up on denials
Verifies and updates patient’s insurance coverage
Investigate and resolve any discrepancies
Answers patient’s billing questions
Posting payments received from patients and third-party payors.
Processes and obtains authorization requests for services (current and retro)
Verifying the accuracy of Authorizations
Using codes to bill insurance providers
Learn and provide assistance to processing bi-weekly payroll.
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Familiarity with classification diagnosis and ICD 10 codes
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Familiarity with billing software such as Sandata, Paycom and others related to the field
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Keeping track of patient data over multiple visits
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Maintain patient confidentiality and information security
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Data entry ability
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Computer literacy and experience in MS word and Excel
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Ability to work well in a team environment. Being able to `prioritizes, delegate tasks if needed, and handle conflict in a reasonable fashion
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Ability to pull correctly reports out of software; paying attention to details.
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Effective communication abilities for phone contacts with insurance payers to resolve issues
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Problem-solving skills to research and resolve discrepancies, denials, appeals, and collections
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Knowledge of medical terminology likely to be encountered in medical claims
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Ability to multitask