Medical Billing Associate - 048624

Purpose/Description

The Medical Billing Associate is responsible for accurately and efficiently processing claims, invoices, and bills to secure reimbursement from insurance companies and clients for medical bills. The Medical Billing Associate will ensure that Department of Health, Human, and Veterans Services providers receive payment for their services in a timely manner, while also maintaining compliance with relevant regulations and coding guidelines. The Medical Billing Associate is responsible for quality improvement planning, verification and eligibility, billing and invoicing, insurance follow-up and patient billing inquiries.

 

 

 

Workday Activities

 

• Required Tasks
  • Review medical records, treatment documentation, and insurance policies to prepare and submit accurate claims for reimbursement.
  • Ensure proper coding (ICD-10, CPT, HCPCS) of medical procedures and diagnoses.
  • Verify patients' insurance coverage and eligibility before submitting claims.
  • Confirm that patients have met their deductibles and co-pays.
  • Generate and send bills and invoices to patients for their portion of medical expenses.
  • Monitor the status of claims submitted to insurance companies.
  • Follow up on unpaid or denied claims, appealing when necessary.
  • Communicate with insurance representatives to resolve billing issues.
  • Assist patients with questions about their bills, insurance coverage, and payment options.
  • Ensure compliance with healthcare billing regulations, including HIPAA.
  • Generate financial reports and statements related to billing and accounts receivable.
  • Provide reports to management for analysis and decision-making.
  • Initiate collections procedures for overdue balances.

• Educational/Experience Requirements
  • Regular Status; AND
  • High school Diploma or equivalent and 5 years of experience as a Medical Biller in a public health or healthcare setting; OR
  • Associate degree and 3 years of experience as a Medical biller in a public health or healthcare setting. OR
  • Bachelor’s degree in related field and 1 year of experience as a Medical biller in a public health or healthcare setting.
  • Certification in medical billing and coding is preferred.

TYPES OF ASSESSMENTS

An Oral Information Assessment (45%) will be administered covering knowledge of knowledge of medical billing software and electronic health record (EHR) systems. Knowledge in medical coding systems, including ICD-10, CPT, and HCPCS. Personal Qualifications Assessment will be rated at (50%).  Experience and Training will be worth (5%). 

Candidates must pass all assessments in order to be placed on the eligibility list.

In the event that the number of eligible applicants is equal to or less than the number required for certification, the Department of Personnel/Human Resources may substitute for the above tests an evaluation of experience and training or such other tests as the Department may deem desirable to determine the competence of the applicants for promotion.

Applicants must comply with the provisions of their union contract regarding career demotions and career shifts. Applications from G.A.A. employees who have regular status in this class (and are employed in this class) or in a class on the same or higher level will not be accepted.

PURPOSE To establish a GAA promotional eligible list from which to fill present and future vacancies. Certifications made for the purpose of filling positions which, at the time of certification, are filled by persons having provisional promotions will be governed by the provisions of Section 6 (e) of Rule 8 of the Rules of the Department of Personnel/Human Resources. The eligible list will remain in effect for one (1) year but may be extended.

GENERAL INFORMATION

The application may be used both for determining admission to the examination and for rating experience and training. Section 5 (b) of Rule 6 of the Rules of the Department of Personnel/Human Resources provides that persons denied permission to compete in an examination may make a written appeal to the Wayne County Civil Service Commission for a final decision within twenty (20) days following the mailing of such notification, stating the basis on which it is felt that their application should