Job Purpose The Biller is responsible for WCNF EDI charge capture and claim submission.
Duties & Responsibilities
- Review referrals to ensure that all charges for each date of service have been captured
- Complete charge corrections into billing system based off office documentation
- Meet and maintain daily productivity and quality standards established in departmental policies
- Adhere to the policies and procedures established for the client/team
- Verify and ensure that patient demographics are properly entered in the host system, correcting errors when necessary and verifying that proper authorizations are entered
- Analyze, identify and resolve issues which may be causing payer payment delays
- Maintain confidentiality and a professional attitude at all times
- Other duties as assigned
- Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
- Understand and comply with Information Security and HIPAA policies and procedures at all times
- Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties
Qualifications
- High school diploma or equivalent required
- Previous experience in Hospital/Facility or Physician billing: preferred
- Experience with EPIC preferred
- Basic knowledge of healthcare claims submissions and processing including
- Knowledge of various types of insurance plans, CPT, ICD-10, billing guidelines
- Proficiency in Microsoft Office Suite
- Strong interpersonal skills, ability to communicate well at all levels of the organization
- Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
- High level of integrity and dependability with a strong sense of urgency and results oriented
- Excellent written and verbal communication skills required
Working Conditions
- Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes
- Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear
- Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress
- Work Environment: The noise level in the work environment is usually minimal
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.
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