Medical Biller Patient Accounts Full Time

Medical Biller

Cost Center 923 Patient Accounts Scheduled Weekly Hours 40 Work Shift First Shift (United States of America) Shift & Status

We at Pine Rest believe in the power of healing and that everyone in our community has the right to expert care for mental health and substance use disorders. We are much more than just the third largest non-profit behavioral health system in the country, our 220-acre main campus, and our network of clinical sites across Michigan. We are a tight-knit community of healers who witness the impact of our life-changing work each day. Each day, we are closing the gaps in access to care. We are innovating through leading-edge research, testing, programs, and treatment modalities that others replicate across the country. Our services include a state-of-the-art psychiatric urgent care center and a soon-to-be-built pediatric behavioral health center, outpatient, inpatient, partial hospitalization (day programs), assessment and testing, residential, addiction treatment and specialty services such as crisis response, employee assistance programs, forensic psychiatry and psychology, and neuromodulation. On-the-job educational programs for nurses, psychologists, advanced practice providers, psychiatrists, and chaplains are equipping the next generation of care providers. We are passionate about serving and are honored to be a part of this incredible work.

What Will You Do?

As a Medical Biller at Pine Rest, you'll be part of a tight-knit team that believes in the healing power of your expertise and compassion. The 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. The Medical Biller is dedicated to excellent customer service, enthusiastic about the care we offer, and foster a sense of belonging and empowerment in a diverse workplace.

Principal Duties and Responsibilities :

• 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.
• Documents all account activity in the account notes.

What Does This Role Require?

Education / Experience :

Benefits :