Description
JOB TITLE : Biller
GENERAL SUMMARY OF DUTIES :
Performs all billing for primary and secondary insurances for Gold Coast Surgicenter. Interacts with business office staff and facility staff as needed to obtain information necessary to submit a clean claim to insurance carriers.
- Resolve claim edits / exclusions
- Understanding billing guidelines and payor requirements.
- Perform prior authorization functions as needed
- Follow-up on unpaid claims to ensure prompt payment based on aging
- Appeal unprocessed and / or unpaid claims to the appropriate insurance carrier;
EDUCATION / EXPERIENCE :
- Two or more years experience in billing and collections in an ASC, preferably
- High School, with 1-2 years experience in healthcare insurance billing and verification, collections, and / or authorizations, appeals
- Partner with AR team members, facility, vendor, and another third party to ensure all documentation needed for billing and collections is achieved.
- Follow up on claims, resolution of billing issues and collaborate with AR Manager and Team Lead for claims denials and appeals in a timely manner.
QUALIFICATIONS :
- Strong interpersonal and organizational skills
- Knowledge of medical terminology and Knowledge of CPT / ICD-10
- Knowledge or medical billing / claim submission procedures
- Billing / coding certification preferred;
- Insurance appeal experience.
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