SENIOR MEDICAL BILLER, Full Time 1.0

Description

This job description defines the tasks and the responsibilities normally expected of the Patient Account Representative/Biller. The primary functions are but not limited to the outlined below. Additional projects, assignments and duties may be given as necessary by the Director of Revenue Cycle.

Responsible for billing all accounts to designated insurance companies. Completing all documentation concerning insurance billing and payments. Review documents on medical procedures performed for accuracy and completeness. Understand referrals, notifications and pre-authorizations for procedures performed. Transmit claims using software programs, follow up on unpaid claims, work submission indexes. Knowledge of insurance providers including Medicare and Medicaid as well as covered practices and procedures. Act as a mentor for all other billers with a thorough understanding of process and procedure.

The ability troubleshoot and problem solve in order to keep patient AR inline with best practices.

This position answers directly to the Director of Revenue Cycle indirectly to the CFO. The policies of Mid-Valley Hospital apply to all written or vocalized actions of this office.

SPECIFICATIONS

Clear understanding of all collections of patient accounts during and after all insurance companies have remitted.

Works with ATB report in a timely fashion with full understanding to read and comprehend the report.

Biller is responsible for working the assigned ques that are assigned daily, weekly, and monthly.

In a courteous and professional manner makes calls or other contacts on delinquent accounts.

In a polite and helpful manner answers questions from patients about their bills and does necessary research on problem accounts.

Perform other duties as assigned by the Director of Revenue Cycle.

Requirements

GENERAL RESPONSIBILITIES

1. Reports for scheduled shift on time and prepared to assume responsibilities.

· Reports to work in proper uniform/attire.

· Leaves for meal break on time and returns on time.

· Varies work schedule to meet the needs of the department.

· Ensures the department manager has approved all scheduled overtime.

· Seek supervisor approval before working beyond scheduled hours that will result in overtime.

· Schedules all time off with supervisor’s approval.

· Strictly adheres to hospital attendance/tardiness policies 100% of the time.

· Performs all duties as assigned.

· Wears I.D. badge in a visible location at all times on hospital property.

· Protects I.D. and access badge and reports any issues or loss immediately to supervisor or to the Human Resource Department.

2. Attends and participates in meetings and is responsible for information communicated at meetings and in email.

· Attends all mandatory in service on a timely basis as scheduled.

· Participates as an active team member at staff meetings.

· Reads communications and acts upon in a positive and informative manner.

3. Responds to all training/recertification notices timely and completes required training and/or recertification prior to deadline or expiration.

4. Exercise a commitment to practicing behaviors that are in agreement with the spirit of cooperation and reflect the values described in the Code of Mutual Respect and Professionalism.

5. Assists all patients, family members, physicians, visitors, and employees in a professional and courteous manner.

· Extends special attention and sensitivity to all patients, visitors, physicians, and fellow employees.

· Actively promote diversity and inclusion across organization for both patients and coworkers while avoiding any language or actions considered to be discriminatory or derogatory regarding race, creed, color, ethnicity, national origin, religion, sex, sexual orientation, gender expression, age, height, weight, physical or mental ability, veteran status, military obligations, and marital status.

· Assists in maintaining an atmosphere of cooperation and teamwork with other departments and community partners.

· Demonstrates a genuine willingness to prevent or resolve inter-personal conflicts.

· Demonstrates the ability to participate in and/or implement team decisions.

· Adheres to HIPAA and all applicable privacy laws at all times, only sharing information on a “need to know” basis.

6. Follows Infection Control procedures at all times.

· Clinical Personnel: Strictly adheres to standard precautions by adhering to the usage of personal protective equipment when handling blood or body fluids.

· Non-Clinical Personnel: Washes hands and other skin surfaces with soap and water thoroughly and often in an effort to control spreading of germs within the department and facility.

· Adheres t