Biller

Full Time · $23.00 – $31.00 Hourly

Job Description

Pay Range: $23.00 to $31.00 per hour, Depends on Experience (DOE)

Summary

Biller performs a variety of clerical duties in the maintenance of clinic patient’s accounts, performing all work with accuracy and in a timely manner. The Biller is responsible for billing third party payers such as Medi-Cal, Medicare, Medicaid Managed Care Plans, County Program and other insurance companies for all services provided by La Maestra Community Health Centers.  The Biller will pursue collection of all claims until payment is made by Medi-Cal, Medicare, Managed Care Plans, County Program and other insurance companies.

Responsibilities

• Performs all data entry requirements needed to accurately and expediently transfer source document data into billing system.
• Responsible for rebilling activity and running reports as needed

• Prepares and processes clinic billing and assists in month end closing process when needed which may include receiving receipts, posting payments and balances to the daily bank deposits.
• Trains other clinic personnel in the use of computer hardware, software, and billing procedures in corporate office or at remote clinic sites.
• Maintains quality control in the area of data entry by proofing work prior to actual posting of transactions.  Maintains accurate source entry materials or documents and maintains a filing system for all assigned bookkeeping.
• Communicates in a professional manner when addressing possible source data inconsistencies with other departments or clinics.
• Answers the telephone and assists customers; responds to inquiries regarding bills and billing procedures and resolves corresponding issues.
• Performs general clerical duties as required, including typing correspondence, copying and filing charts and other documents, entering computer data, maintaining logs and compiling data for reports.
• Completes and submits PM160 Forms as needed
• Claim remedy
• Processes and posts sliding fee payments
• Operates a variety of office equipment including, computers, printers, typewriter, copier, calculator, fax machine, telephone, etc.
• Prepares and submits claims to Medi-Cal, Medicare, Medicaid Managed Care Plans, County Program and other third party insurance carriers either electronically or by hard copy billing.
• Performs all data entry requirements needed to accurately and expediently transfer source document data into billing system
• Secures needed medical documentation required or requested Medi-Cal, Medicare, Medicaid Managed Care Plans,  County Program and other third party insurances.
• Follows-up with Medi-Cal, Medicare, Medicaid Managed Care Plans, County Program and other third party insurance carriers on unpaid claims until claims are paid
• Processes denials by correcting any billing error and resubmitting claims to third party insurance carriers.
• Understands and applies Medicare wrap around payments
• Makes collection calls to self-pay/private pay patients to notify them when claims have not been paid after time frames in established accounts receivable policy.
• Keeps updated on all billing and benefit changes for third party insurance carriers.
• Monitors claims for missing information, authorization/ control numbers.
• Keeps updated on all third party billing requirements and changes for insurance types within their area of responsibility.
• Maintains quality control in the area of data entry by proofing work prior to actual posting of transactions. Maintains accurate source entry materials or documents and maintains a filing system as needed

Job Requirements

Education:  High School Diploma or GED

Certification required:  Billing and Coding Certificate preferred. Active CPR Certification.

Experience:  1-2 years’ experience in billing in a Community Healthcare setting preferred.

Verbal and Written Skills to perform the job:  Bilingual (English/Spanish) preferred. Familiarity with basic word processing, spreadsheet, and database applications.  Accurate keyboarding skills.

Technical knowledge and skills required to perform the job:  Excellent verbal, written and interpersonal communication skills and the demonstrated ability to work with diverse individuals and groups.  Demonstrate high levels of self-initiation and direction. Knowledge of communities we serve. Knowledge and experience working in medical settings and interacting collaboratively with medical teams.  Skill in analyzing situations and making timely decisions.

Physical and Mental Requirements:  Work involves sitting, talking, hearing, using hands to handle, feel or operate objects, tools, or controls, and reaching with hands and arms. The employee may be required to push, pull, lift, and/or carry up to 20 pounds. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

La Maestra Community Health Centers is an equal opportunity employer and does not discriminate on the basis of race, religion, color, sex, national origin, age, sexual orientation, gender, disability or any other legally protected status.