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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.

• Expertly review patient accounts and verify insurance information.
• Apply correct coding and prepare/transmit claims.
• Diligently follow up on rejections and denials to maximize revenue capture.
• Demonstrate outstanding attention to detail and strong knowledge of billing regulations.
• Contribute 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

• 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.
• Resolves incoming correspondence or telephone inquiries in a timely manner.
• Identifies trends and patterns in claims processing and participates in process improvement.
• Documents on system all actions taken on account.
• Demonstrates knowledge and use of Cerner, the Billing clearing house, and other related PFS software.
• Displays competency in the use of departmental equipment.
• Performs routine assignments independently and prioritizes workload.
• Reports problems, questions, or suggestions to immediate supervisor.
• 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, upon hire.
• Two years relevant college education and experience, upon hire.
• Experience with Google Workplace applications, Billing clearing house, and Cerner.