School Health Medical Biller
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About The Position
The School Health Medical Biller is a crucial role responsible for managing the complete claim submission and follow-up process for local educational agencies (LEAs). This position requires collaboration with Managed Care Plans, the Department of Health Care Services, government agencies, and educational institutions to ensure the sustainability of school health programs. The responsibilities include claims editing, coding, billing and claims submission, follow-up with insurance providers, and adjustment of claims as necessary. The biller may also be assigned to specific programs such as the LEA Billing Options Program (BOP) and the Multi Payor School Linked Fee Schedule, among others. In this role, the Medical Biller will review service details and edit claims to rectify any billing errors. They will follow up with school providers to gather additional information needed for resubmission and provide clarification on billing practices and service documentation requirements based on the processing of claims by payors. The position also involves verifying patient eligibility through provider portals or by contacting insurance companies, updating claims with accurate medical codes, and ensuring high coding accuracy for CPT and ICD codes. Maintaining patient records and ensuring the accurate processing of these records is also a key responsibility. The Medical Biller will monitor claim volumes and ensure timely processing for all school-based providers, contributing to the overall efficiency of the school health programs.
