Medical Biller

Job Description

Job Description

Description : We are Hiring!

Job Posting : Medical Biller

Location : Remote / In-office 1 day week at 1150 Buffalo Rd

Employment Type : Full-Time

Department : Finance

Salary : $22-$24 / hr

Catholic Charities of the Diocese of Rochester was founded in 1917 with a mission to build a just and compassionate society to advance the dignity of all people. Catholic Charities of the meets basic needs; advances economic security; pursues housing solutions; strengthens families and children; delivers compassionate mental health and addiction care; supports individuals with intellectual and developmental disabilities; welcomes immigrants and refugees, and more.

If you’re looking for an opportunity to express and explore your passion for helping others, then join a team that truly makes a difference DAILY, in people's lives. Don't miss out on being a part of something special!

About the Role :

Under supervision, processes, and bills medical and rent charges. Works claim denials and outstanding Invoices for all Medicaid, MCO, Commercial and County payers for agency programs. Effectively supports ongoing and collaborative communication amongst all program staff and is responsible for ensuring a trauma informed care environment.

Key Responsibilities :

• Bills medical claims for all Medicaid, MCO and Commercial Insurance payers for all assigned programs.
• Creates charges in billing system daily
• Reviews Responsible Party charges for verification of insurance and makes corrections as needed
• Requests authorizations for outpatient services when required by payer
• Reviews and corrects any front-end billing edits prior to submitting claim batches to clearinghouse by working directly with billing support when needed.
• Batches claims and uploads to clearinghouse or directly to payer
• Reviews, corrects, and resubmits any clearinghouse or insurance claim rejection error messages by working directly with clearinghouse or billing support when needed.
• Completes paper claim forms (UB- 04 and HCFA1500) and mails directly to payer when needed
• Troubleshoots billing issues when necessary
• Works Denials for all Medicaid, MCO and commercial payers for all assigned programs.
• Works and resolves daily denials received from all payers
• Follows up on outstanding accounts receivables for all payers
• Processes all refunds and claim adjustments requests received by compliance
• Submits refunds to payers in a timely manner to resolve credit balances
• Ensures the claims and denials are followed up on in a timely manner to ensure collection of payment
• Utilizes claims management to track and report on claim status and to ensure a timely follow-up process is followed
• Performs adjustments and write offs to client accounts for all assigned programs.
• Requests appropriate approval prior to processing any write offs
• Adheres to all applicable federal and state laws, including but not limited to those governing client confidentiality, privacy, program standards and billing and documentation standards.
• Has knowledge of federal and state standards governing program documentation and Medicaid and Medicare billing standards and completion of all required service documentation in accordance with such standards
• Maintains up-to-date professional knowledge through reading, workshops / trainings, and conferences, as appropriate
• Participates in relevant Agency meetings and / or trainings
• Actively pursues development of professional competencies related to job role performance through reading, supervision, in-service training and attendance at conferences and workshops.

Requirements : Qualifications :

Preferred Skills :

Top Benefits and Perks :

Join us and help make a positive impact in our community!