What are the responsibilities and job description for the Bill Processor: Hybrid position at NJM Insurance Group?
Our West Trenton Medical Services Administration team is in search of a Billing Processor. Reporting to the designated supervisor, the Billing Processor is responsible and accountable to review assigned billing statements on a daily basis. This exciting opportunity is great for someone who is highly organized and enjoys working in a fast-paced environment.
This role can report to either our West Trenton or Hammonton office.
Six months training will be provided. Once complete the role will offer a Hybrid schedule of 2 days in the office and 3 days at home.
Job Responsibilities
- Audit and process medical bills within statutory timeframes, by following medical coding guidelines and department policies and procedures
- Verify correct payee and provider information and ensure that all bills that meet audit criteria are routed immediately for audit purposes.
- Communicate with claims personnel relating to complex issues regarding authorizations, pre-certifications and compensability.
- Apply state fee schedules when appropriate
- Review and respond to MSA QC (Quality Control) issues including current billing questions, retroactive billing concerns, stops and reimbursement requests.
- Research and respond by telephone/email to provider inquiries regarding billing issues in a timely manner
Required Qualifications and Experience
- Verify correct payee and provider information and ensure that all bills that meet audit criteria are routed immediately for audit purposes.
- Communicate with claims personnel relating to complex issues regarding authorizations, pre-certifications and compensability.
- Apply state fee schedules when appropriate
- Review and respond to MSA QC (Quality Control) issues including current billing questions, retroactive billing concerns, stops and reimbursement requests.
- Research and respond by telephone/email to provider inquiries regarding billing issues in a timely manner
- A medical background with billing/coding experience or education is required
- Knowledge of CPT (Current Procedural Terminology) and ICD-10 codes required
- Multi-state knowledge for Workers’ Compensation and/or Personal Auto (PIP) a plus
- Strong communication skills, including writing, speaking and active listening
- Ability to learn quickly, work in fast paced environment and adapt to change
- Organization, time management and prioritization abilities
- Strong interpersonal and customer service skills
- Ability to balance priorities by responding to customer concerns while performing thorough investigations of all issues encountered
- Multi-tasking, problem-solving and decision-making abilities
- Effective computer skills and ability to work in multiple systems
- Ability to work independently
- High School Diploma or GED required
Legal Disclaimer: NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.