Medical Biller

Job Title : Medical Biller / Collector III

Duration : 06 months Contract

Location : 4900 Rivergrade Road, Irwindale, CA 91706

Shift Type : 8am – 5pm M-F

pay range : $20 - 28 / hr. (Pay range depending on the experience)

Responsibilities :

• Generates monthly work files for staff based on monthly review of volume and internal policies and procedures or as needed.
• Facilitates communications with payers to address outstanding claims, denials, or remits to resolve payment variances, and works to develop and maintain positive relationships with payers.
• Initiates communications with providers to address any outstanding issues impacting revenue; makes recommendations for resolving and / or improving the flow of data and maximizing charge capture.
• Reviews denial reason codes and underpayments to identify root causes; works with payer contracting and other areas of the revenue cycle if necessary to resolve issues.
• Analyzes data to track and identify trends and provides team with updates and ideas for improvement.
• Assists staff in identifying high-risk accounts and prioritizing resolution efforts; Ensures staff is researching high dollar accounts, high volume denials, credits, adjustments, and undistributed balances, etc. in adherence to internal policies and procedures.
• Maintains superior understanding of CPT / HCPCS codes, ICD-10 codes, CMS 1500 form guidelines, eligibility and coverage requirements, remit and remark codes, payor / plan codes, claims management, third-party payer guidelines, state and federal regulations, claims clearinghouse workflow, and all other pertinent functions of the job.
• Has thorough knowledge of managed care contracts, DOFRs, reimbursement rates, and other billing requirements mandated by said agreements with payors.
• Collaborates with other departments to identify best-practice strategies, align goals, and improve collections.
• Ensures staff is working work queues in adherence to internal policies and procedures.
• Ensures that all necessary documentation and information is correct according to divisional policies and procedures for approval of charge corrections and refunds.

Skills :

• Demonstrated knowledge of claims review and analysis; ICD-10, CPT, and HCPCS coding; and medicaleXPLA
• Terminology
• Effective communication, leadership, organizational, and problem-solving skills
• Ability to manage multiple tasks and projects simultaneously
• Ability to analyze data, identify improvement, and implement change
• Demonstrated written and verbal communication skills. Ability to plan and carry out responsibilities with minor supervision
• Excellent verbal and written communication skills
• Excellent interpersonal skills with customer service focus

Experience

• Minimum of 2 - 7 years of experience performing medical billing functions. Minimum experience includes corresponding with insurance companies in resolving patient accounts.
• Extensive knowledge of insurance carrier procedures, including Medicare, Medi-Cal and other third-party payors. Experience with reading Explanations of Benefits (EOB) statements.
• Proven ability to handle multiple conflicting tasks

Education / Experience :

High school diploma or equivalent