Medical Biller I

St Johns Community Health•Los Angeles, CA

About The Position

The Medical Biller I is a full-time position responsible for the coding and billing of Medical, Dental, Optometry, Behavioral Health, OB-GYN, and Podiatry, claims. This position reports to the Billing Manager, in some cases, the focus may be on either coding or billing but must be cross trained in both.

Requirements

Three (3) years of experience with revenue cycle operations management with excellent presentation and writing skills.
Advanced skills in analysis and MS Office suite.
High School diploma or GED required.
Billing Certification required.
Demonstrated knowledge of all Insurance companies, HMO’s, PPO’s Government and State programs Medi-Cal and Medicare, and third-party payers.
Experience with managing revenue cycle processes including Medicaid and Medi-Cal eligibility, health information management and billing, and charge capture processes.

Nice To Haves

eClinical Works experience is preferred.

Responsibilities

The billing department encompasses medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management.
Works through patient insurance documentation, billing and collections, and data processing to ensure accurate billing and efficient account collection.
Serves as a practice expert and go-to person for coding and billing questions and advice.
Analyzes billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues.
Follows up on claims using various systems, such as eClinical Works, Claim Remedi clearinghouse, Payer portals, etc.
Maintains contacts with other departments to obtain and analyze patient information to document and process billings.
Keeps up to date with carrier rule changes.
Successfully scrubs and quality controls claims prior to submission.
Works rejected claims and provides necessary follow-up to ensure successful claim processing.
Maintains strong attention to detail and ability to multi-task.
Maintains extremely high standards of professional conduct.
Establishes and maintains effective working relationships with the office staff and Doctors.
Adheres to policies regarding safety, confidentiality, and HIPAA guidelines.
Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol and are in compliance with Federal, State, and payer regulations, guidelines, and requirements.