Biller Jobs

About The Position

Requirements

• Microsoft Office/Word/Excel/Outlook
• Excellent Communication Skills
• Excellent Customer Service Skills
• Ability to work as a team player and work independently
• Reliable transportation
• Must be able to travel from facility to facility
• High school or GED equivalent
• Certificate in medical billing
• Knowledge of HCPCS, CPT and ICD9
• Medical terminology
• Commitment to goals and philosophy of Northeast Community Clinic
• Valid State Identification

Nice To Haves

• Knowledge of Medi/Cal reimbursement guidelines
• Bi-lingual Spanish/English

Responsibilities

• Submit/generate claim(s) file(s) to health insurance plans, both paper and electronic on a weekly basis and ensure their receipt (e.g. PM160, CMS1500, email ticket, volser etc…)
• Submit/generate encounter(s) to the appropriate IPA/ health plans, both paper and electronic on a weekly basis and ensure their receipt (e.g. PM160, CMS1500, email ticket, volser etc…)
• Post Remittance Advice and Explanation of Benefits, both paper and electronic on a weekly basis.
• Organize superbills (e.g. file, scan, label, etc…)
• Interface with billing/clinic staff and providers to obtain any required information needed to enter and bill/rebill a claim (e.g. correct payor on superbill, authorizations, diagnosis, etc…)
• Generate/re-generate superbills (e.g. hospital round etc…)
• Generate/create various reports/invoice (e.g. hospital round, MAOF, “Daily Superbill Report”, etc…)
• Adjudicate all claim types.
• Provide back-up support to clinical biller, ensuring claim deadlines are met by creating claims entering all superbills generated on a daily basis from clinic site(s).
• QA superbills for accurate data entry (e.g. eligibility, payer, diagnosis, etc…)
• Ensure completeness of claims for proper payment (e.g. PM160, CMS1500, attachments etc…)
• Provide superbills or any attachment(s) requested (e.g. rebilling, HEDIS, superbills for audit, etc…)
• Contact insurance vendors (e.g. eligibility, denials, claims submission, etc…)
• Assist in billing projects.
• Attend trainings, meeting, workshops and webinars as needed.
• Provider back-up support to receptionist is out.
• Will perform other related duties as assigned by the Billing Supervisor, Billing Manager, Controller, Finance Director or Executive Director.