Medical Biller

POSITION SUMMARY

As a Medical Biller at MASS LUNG & ALLERGY (MLA) this position performs a wide variety of duties and responsibilities in a manner that places emphasis on quality of care and customer service. The incumbent must work collaboratively with all staff in support of patient services, exhibiting flexibility and a "can-do" attitude. Patient services are the key priority in this position requiring the Medical Biller to serve as a point of contact with other internal and external departments, all with the goal of fostering an environment which promotes patient comfort and trust. The position must exemplify the core values and mission of the organization, always exercising utmost discretion, diplomacy, and tact in patient/staff interactions.

60% DUTIES AND RESPONSIBILITIES:

• Register and verify insurances for inpatient/outpatient hospital, pulmonary function test readings, sleep study readings and nursing home claims.
• Verifies completeness and accuracy of all claims prior to submission.
• Referral and Authorization follow up, Insurance verification as necessary.
• Transmit claims using billing software, including electronic and paper claim submissions.
• Review and correct clearinghouse rejections as necessary.
• Follow up on unpaid claims, investigate denials, resubmit corrected claims, appeals.
• Patient Statements.
• Patient Collections.
• Collection's agency requests.
• Returned mail.
• ERA and EOB payment posting- including Zero pays
• Setting up patient payment plans and work collection accounts.
• Running collection reports.
• Provide patients with support and guidance as needed.
• Attends staff and administrative meetings, as required.
• Performs all duties and service in full compliance with MLA's Service Excellence Standards.
• Performs all duties in support of successful EHR/EPM implementation.
• Maintains workstation, according to protocols (free of meals and open beverages).
• Acts in capacity as an interpreter, only if certified to do so as needed.
• Performs additional duties, as assigned by the Manager and in support of quality assurance and improvement.

30% QUALIFICATIONS:

• Excellent written and verbal communication and problem-solving skills
• Intermediate computer skills- including but not limited to electronic medical records (EMR) software, Microsoft word and excel applications.
• CPT and ICD-10 coding, familiarity with medical terminology
• Excellent customer service skills.
• Demonstrates professionalism at all times.
• Possess a thorough understanding of the importance of confidentiality and non-disclosure according to the general standards set forth by HIPAA.
• Ability to manage relationships with various Insurance payers.
• Demonstrates flexibility in regard to job duties and assignments.

10% EDUCATION AND EXPERIENCE:

• High school Graduate (or GED) required.
• 2+ years' experience as a Medical Biller
• Certification Professional Coder
• Proficiency with electronic medical records (EMR)
• Ability to work independently and collaboratively within a team environment