Insurance Biller II

Neighborhood Healthcare•Escondido, CA

50d•$26 - $32•Hybrid

About The Position

The Insurance Biller II works to support the mission and vision of Neighborhood Healthcare (NHC) by processing and supporting the medical billing process for patients and other funding sources. This role will validate correct coding processes to ensure compliance with NHC, contracts, funding programs, and agencies. This is a hybrid position with a typical schedule of 2 days onsite and 3 days remote. This role will also be expected to come onsite for department meetings every 2 months.

Requirements

High school diploma/GED required
Two years of medical billing experience in a healthcare environment required
Excellent verbal and written communication skills, including superior composition, typing and proofreading skills
Ability to interpret a variety of instructions in written, oral, diagram, or schedule form
Knowledgeable about and experience with insurance eligibility processes and coverage guidelines for multiple carriers
Knowledgeable about and experience with billing compliance standards
Knowledgeable on uses of CPT, HCPCS, and ICD codes
Knowledgeable with insurance payers, funding sources, and managed care plans.
Ability to successfully manage multiple tasks simultaneously
Excellent planning and organizational ability
Ability to work as part of a team as well as independently
Ability to work with highly confidential information in a professional and ethical manner

Nice To Haves

Medical Billing or Coding Certification from an accredited school preferred
Experience working in a specialty and/or FQHC community clinic is preferred

Responsibilities

Reviews progress notes to obtain payer measures and requirements information for proper submission compliance
Reviews and obtains required information for missing and incomplete billings, such as missing DX, procedure codes, payer specific needs, eligibility screening, and coverage verification
Creates and submits claims for clean billable charges and statements in compliance of correct coding initiatives and billing industry requirements
Processes and monitors system claim status categories to ensure all transactions are captured for month end close
Registers patients in the payment portal, as needed
Reviews, processes, and obtains patient eligibility information to ensure accuracy and completion, including acquisition of authorization numbers, as needed
Applies discounts to billing statements for patients eligible for the Sliding Fee Discount Program (SFDP), as needed
Posts patient and insurance payments to account balance adjustments and write offs, as assigned
Monitors and reports insurance payment denials, including coding issues and benefit changes
Reviews and processes aging claims and denials, including claim tracers, corrected claim submissions, appeals, and consistent revenue flow
Reviews and processes refunds and insurance recoupment requests
Submits patient statements on cash accounts, as needed
Processes monthly collection accounts for collection agencies, as needed
Supports site related phone lines and voicemails; returns calls, as needed
Discusses escalated billing inquiries with patients, third party payers, and/or sites to resolve account questions and/or problems
Negotiates payment plans with patients, as needed
Provides excellent customer service to patients and escalate issues to a supervisor, if needed
Responds to site, insurance, and patient correspondences related to billing in a timely manner
Attends billing training and team meetings