Biller

Job Description

Job Description

New England Life Care (NELC) is one of the fastest growing home infusion therapy companies in New England and is the region’s only non-profit home infusion provider.

NELC is a hospital collaborative serving more than 60 hospital systems in Maine, New Hampshire, and Massachusetts. NELC was created by local hospitals to ensure their patients have access to a provider that reflects their commitment to excellence in patient care, quality, and service.

Like our owner hospitals, NELC provides patient focused care.

New England Life Care has and continues to build a diverse, inclusive, and authentic workplace, so if you’re energized by this opportunity, but your experience doesn’t support every qualification in the job posting, we encourage you to apply! You still may be the person we are looking for!

New England Life Care currently has a Hybrid Biller position available. The normal schedule is Monday - Friday from 8 : 00am until 4 : 30pm.

This is a hybrid position which will require the applicant to be onsite 2-3 days each week

Job Summary : The biller is responsible for the billing of insurances and patients.

Career Ladders : NELC’s billing department offers career ladders to Billers. Candidates who achieve excellent performance in their job duties, who demonstrate a commitment to personal development, participation in department and company strategic programs and projects, who develop superior working relationships inside and outside the department and who show a commitment to the success of the department are eligible for promotion to the following positions :

Biller represents an entry level position into the department. Candidates who meet defined goals, objectives and accomplishments can generally expect to be promoted in 2-3 years to :

Senior Biller - Candidates who meet defined goals, objectives and accomplishments and who demonstrate engagement and ownership of departmental and organization activities would generally expect to be promoted in 4-5 years to :

Lead Biller Candidates who are part of the department leadership team and who have responsibility for advanced departmental, company and member hospital engagement.

Benefits :

• Career Ladder
• Health insurance
• Dental insurance
• Vision insurance
• Generous employer-matched 403b savings program
• Company paid : Life insurance, Short- and long-term disability insurance
• Paid time off
• And much more!

Responsibilities :

• Achieve performance appraisals with "meets expectations" or better
• Demonstrate independence and competence and ability to review and navigate patient accounts and delivery tickets
• Demonstrate independence and competence and ability to create and accept claims from clearing houses and work claim rejections
• Demonstrate independence and competence in working daily billing reports
• Demonstrate independence and competence and ability to teach basic billing knowledge, splitting claims, recognize billing and account errors, work To Do's and send out daily goal emails
• Demonstrate independence and competence and ability to bill 20 or more clean claims a day
• Demonstrate independence and competence and ability to bill using the payor sheets
• Demonstrate independence and competence and ability to teach how to navigate through patient accounts and delivery tickets
• Maintain average of 95%or better in claim audits
• All billing queues reviewed weekly
• Billing rejections worked daily from queue
• To do's completed within 2 days

Education :

• 3 years’ experience in healthcare setting processing healthcare provider claims or comparative experience in a healthcare setting required.
• A working knowledge of government health insurance plan benefits and the rules & regulations for obtaining reimbursement required.
• Experience with healthcare patient accounting / billing / collections computer applications including electronic claims processing preferred.
• Working knowledge of Home Infusion Therapy billing & collection preferred. Diploma

Required Qualifications :

• 1 year experience in healthcare setting processing healthcare provider claims or comparative experience in a healthcare setting required.
• A working knowledge of government health insurance plan benefits and the rules & regulations for obtaining reimbursement required.
• Knowledge of HIPAA Privacy and Security requirements.
• Working knowledge of federal / state fraud and abuse laws required.
• Demonstrated knowledge of medical terminology; CPT; ICD9; and HCPC coding required.
• Excellent customer service skills required.
• Excellent communications skills required.
• Excellent organizational skills required.
• Ability to work independently as well as part of a team required.
• Practical experience with microcomputer systems and applications to include Microsoft Word and Excel required.
• Demonstrated ability to identify research and solve problems required.

Preferred Qualifications :

• Associate degree
• Demonstrated knowledge of medical terminology; CPT; ICD9; and HCPC coding required.
• Excellent customer service skills required.
• Excellent communications skills required.
• Excellent organizational skills required.
• Ability to work independently as well as part of a team required.
• Practical experience with microcomputer systems and applications to include Microsoft Word and Excel required.
• Demonstrated ability to identify research and solve problems required.
8 days ago