Professional Insurance Biller
About The Position
The Professional Biller manages patient billing activities, including claim processing, payment handling, and revenue cycle management. The role serves as a liaison among healthcare providers, patients, and insurance companies to support accurate and efficient billing. Duties include reviewing bills for accuracy, submitting and following up on insurance claims, resolving discrepancies, communicating with payers, responding to patient inquiries, performing collection activities, and complying with privacy and billing regulations. The position requires staying informed about changing billing procedures and regulations.
Requirements
- High school diploma or GED.
- Minimum of 3 years of billing experience.
- Comprehensive working knowledge of medical terminology, CPT, HCPCS, ICD-10, insurance billing, and appeals processes.
- Knowledge and use of Office, PC, Microsoft Office, EHR, Epic billing software, and basic office equipment.
- Basic knowledge of Knox-Keene, ERISA, and California state laws affecting billing.
- Basic knowledge of HIPAA and California state confidentiality laws affecting the release of medical information.
- Superior oral, written, and listening skills when dealing with patients, physicians' office staff, coworkers, and payers.
- Good organizational skills and flexibility.
- Ability to make reasonable independent decisions within hospital and department guidelines without immediate direct supervision.
- Ability to multitask and reprioritize workload to meet deadlines.
- 30 CWPM data entry, ten-key skills, basic filing skills, alphabetic and numeric skills, and basic math skills.
- Ability to interpret insurance contracts and rate sheets.
Nice To Haves
- Current working knowledge of Medicare, Medi-Cal, RHC, commercial insurance, workers' compensation, and other payers.
- Understanding of governmental agencies, commercial insurance, and state and county compliance guidelines related to billing.
Responsibilities
- Process claims, payments, and other patient billing activities.
- Review bills for accuracy.
- Submit and follow up on insurance claims.
- Resolve billing discrepancies and communicate with payers.
- Respond to patient billing inquiries and perform collection activities.
- Comply with privacy and billing regulations and stay informed about changing procedures and regulations.
- Assist coworkers during peak workloads and short staffing.
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
