BILLER

Location/Department: Occupational Health and Wellness Clinic (Batesville)

80 hours per pay period - Benefit eligible

Job Summary:

Responsible for all occupational health billing & payment posting. Understands top occupational health E&M codes & CPT codes. Works denials. Import/export billing data. Reviews & corrects claim edits by payer. Investigate medical necessity edits for billing validation. Reconcile claim volume reports. Healthcare billing experience needed. Update & maintain correct physician identification numbers as required by specific insurance carriers. Knowledgeable in federal & state compliance regulations required for accurate & timely billing of insurance claims. Knowledgeable in software & revenue cycle software systems.

Supervisory Responsibilities: None

Duties/Responsibilities:

• Call for pre-authorizations/pre-cert as needed.
• Insurance verification of eligibility & benefits.
• Scan all authorizations & eligibility into medical records.
• Verifies insurance information is correct & up to date on all companies & private practice patients.
• Maintains up-to-date work comp carrier information & company contacts.
• Print claims at least weekly.
• Handles billing inquiries from patient/family/company.
• Performs processes to close routinely & month end.
• Review closing to ensure all batches have closed properly.
• Monitor for billing errors on invoices & statements.
• Process claims batches by specific payer requirements, review & update required data as needed.
• Submit electronic claims.
• Send claims to specified (non-electronic) payers.
• Review accounts on hold, update edits & claim corrections & transmit claims for processing daily.
• Edit claims.
• Work with vendor & review outsourcing billing issues, transmission problems & follow up until resolved.
• Create transmission file & submit electronic claims to clearinghouse daily.
• Perform system backup of daily claims transmitted.
• Review & reconcile electronic & generic (non-electronic) claim reports. Rework rejected claims by specific payer & resubmit.
• Complete batch postings daily.
• Follow up on outstanding invoices.
• Posts payments/adjustments.
• Maintain accurate financial records & payment procedures.
• Compiles monthly reports as requested.
• Provides A/R reports monthly.
• Other reports as needed by management.
• Understands software updates related to billing.
• Works with clinical analyst with any software issues.
• Maintain rendering physician numbers as needed by each payer.
• Update & maintain claim dictionaries needed for billing types & payers as needed.
• Update charge master.
• Process payments at least weekly.
• Monitors & reports days in AR monthly.
• Works closely with Finance on ACH payments.
• Complete billing batch postings & processes EFT check postings.
• Reconciles all accounts accurately.
• Answers phone, schedules appointments, check in/check out patients.
• Check voicemail & follow up appropriately.
• Collect co-pays, balances, & self-pay payments.
• Keep work area clean & supplies at par level.
• Mail information to companies/patients as requested.
• Manage incoming & outgoing mail.
• Other duties as assigned or delegated.
• Works closely with hospital billing department.
• Continuous process improvement on billing workflow to ensure efficient & accurate work.
• Maintain up to date & accurate patient data, company data, provider & insurance data.
• Maintains current knowledge of occupational health & wellness billing procedures.

Required Skills/Abilities:

• Strong communication & customer service skills.
• Detail-oriented, demonstrates skill in time management.
• Strong math, bookkeeping & accounting skills.
• Able to operate a computer & basic office equipment; excellent data entry skills.
• Proficient in Microsoft Office.

Education and Experience:

• High school diploma or equivalent.
• Minimum of 1 year relevant work experience required.

Physical Requirements:

• Work requires constant sitting, manual dexterity, use of hands & talking; frequent reaching & occasional walking, pushing, stooping, & standing.
• Occasionally may need to lift up to 25 – 50lbs.