Patient Financial Services - Biller 1

Mercyhealth Wisconsin and Illinois•Remote-Illinois, IL

4d•$18 - $26•Onsite

About The Position

The Patient Financial Services - Biller 1 position is responsible for submitting medical claims electronically and manually, ensuring clean claims through the use of available technology. This role involves interpreting claims processing reports, maintaining knowledge of regulatory billing requirements, and making necessary demographic changes. The Biller 1 must be able to analyze coding for proper billing, participate in educational programs to maintain skills, and request/attach required clinical documentation. They will review and resolve failed claims due to edits or billing errors, utilize resources to find missing information, and apply problem-solving skills to overcome obstacles. This position also coordinates with management and external departments to resolve unbilled accounts and may recommend process redesign. Additionally, the Biller 1 must stay updated on insurance company changes and Federal/State guidelines, and meet assigned productivity goals.

Requirements

High school diploma or equivalent.
Microsoft Excel required.
Must have the ability to analyze coding to assure proper billing of claim.
Should understand how to work with others to impact change.

Nice To Haves

Healthcare billing experience preferred.
Undertakes self-development activities.

Responsibilities

Submits medical claims both electronically and manually, and uses all technology available to produce clean claims for their assigned workgroup.
Interprets claims processing reports and applies information to produce clean claims.
Maintains current knowledge of regulatory billing requirements.
Makes changes to demographic information as necessary in order to produce a clean claim.
Analyzes coding to assure proper billing of claim.
Participates in a variety of hospital and physician educational programs to maintain current skill and competency levels.
Requests and attaches required clinical documentation in accordance with third party requirements.
Reviews failed claims; resolve claims stopped for claim edits, or billing errors.
Access available resources, such as the patient accounting system, biller files, or payer databases, to locate missing or incorrect information.
Apply creative problem solving skills in order to overcome obstacles and resolve errors.
Coordinate with management and external departments to resolve unbilled accounts and potentially recommend process redesign initiatives for long term root cause resolution.
Completes special projects as assigned.
Maintains a comprehensive awareness of insurance company updates including Federal and State guidelines.
Meets productivity goals as assigned by the Revenue Cycle Director.