The Lead Medical Biller, according to general directives and established departmental and or Pine Rest Christian Mental Health Services policies and procedures, independently performs administrative duties related to billing, to include but not limited compiling data, generating claims for services rendered, and compiling fees and charges. This position is also responsible for supporting the oversight of the billing team and assisting the manager in projects that ensure compliancy and success of activities of the team. The Lead Medical Biller must demonstrate excellent customer service and have enthusiasm about the program and the Pine Rest organization.
What Will You Do?
Ensures the accuracy and completeness of patient financial, insurance and demographic patient information to ensure compliant claims to Third party payers. Submit claims to payers assuring claims meet the clean claim definition to assure timely and accurate payment. Maintain knowledge of payer regulations, contracts and billing requirements and act as a resource to clinical sites regarding these requirements. Contact insurance companies to obtain preauthorization (in some departments), resolve outstanding balances, incorrect payments, claim denials or information needed to adjudicate claims. Work with clinical areas to resolve rejections and determine collectability or need for adjustment. Process payment/claim resolution documents, making determinations on balances based on contractual arrangements and insurance coverage. Review insurance credits and take appropriate steps to resolve credit. Maintains quality and productivity standards set by management and documents all account activity in the account notes. Create and maintain customer-friendly environment with internal and external customers. Responsible for the monitoring and careful use of resources impacting them in a moderate capacity. Uploads daily claim and statement files to vendors and payers. Assists in the training and education of billing staff upon hire and ongoing, and as new systems, processes or payers are created. Mentors billing staff on problem resolution as needed. Assists manager in day-to-day operations. May prepare special reports as directed by manager to document follow-up services, e.g., number of claims and dollars billed, claims edited, claims unprocessed. Responsible for completing billing projects as assigned by manager. May support and promote a recovery focused environment and person-centered approach within the program. Responsible to uphold the healing ministry of Christ through relationships that honor integrity, stewardship, empowerment, the promotion of diversity, equity, inclusion, and professional excellence. The Lead Medical Biller must maintain annual training and demonstrate competency in the required programmatic training
Who Are We?
Diversity, inclusion, and equity are at the core of Pine Rest. We strive each day to foster a sense of belonging and empowerment in a diverse workplace.
Pine Rest believes in investing in our greatest resource: our employees. We encourage you to take advantage of all opportunities for professional development. Through our own development with that of Pine Rest we can continue to advance mental health care in our communities.
What Does This Role Require?
- High School diploma or equivalent required, associate degree preferred.
- Three (3) years of hospital or professional billing experience required. Knowledge of Medical terminology and/or healthcare revenue cycle experience preferred.
- Work requires the ability to read, understand and follow directions, and do computations.
What Benefits Do We Offer?
- Quality, cost-effective health care
- 403(b) retirement plan
- Tuition reimbursement
- Employee assistance program
- Strong compensation commensurate with experience
How Do I Apply?
Please submit your resume and cover letter to: talentacquisition@pinerest.org
Or simply apply via our careers page: www.pinerest.org/join-our-team
Thank you for your interest in working for Pine Rest Christian Mental Health Services. We appreciate your time and look forward to reviewing your resume. If you are selected to participate in the interview process, you will receive an email or phone call within 2 weeks.