Medical Biller/ Billing Representative

Medical Biller/ Billing Representative

Medical Biller/ Billing Representative



Summary

Under general supervision of the Billing Department Manager, acts as internal/external public relations agent, gathering charge information, codes, entering into on-line data base, and completes billing process for HMOs, PPOs, and Medi-Cal insurances. Performs a variety of clerical duties and provides patients with insurance and billing information. 

Essential Duties and Responsibilities includes but not limited to the following:

• Researches and verifies all information needed to complete accurate billing process including verifying/obtaining charge information from physicians/ providers.
  
• Works with practice management system to follow-up on accounts until zero balance is achieved or submitted to collections for processing.
  
• Assists internal (staff) and external (insurance companies) with coding and billing error resolutions.
  
• Maintains current and accurate billing records, reports and files.  Identifies and corrects patient account and insurance errors.
  
• Works with administration on patient billing and credit issues.
  
• Accurately, completes necessary paperwork/documentation and uses computer to generate information necessary for billing. Updates patient information, provides necessary forms/supporting documentation, and obtains essential billing information and signatures as required.  According to payer procedures uses computer to generate documents, reviews EOB information for accuracy, and updates and/or corrects information as necessary.
  
• Keys charge information into on-line entry program and produces billing.
  
• Greets patients/customers in polite, prompt, pleasant and helpful manner. Provides directions, billing information, registration and other assistance as needed.
  
• Answers multi-line phones in a pleasant manner and deals with customers needs expeditiously, records messages for staff/providers and facilitates inter-office communications.  Answers patient questions, inquiries, and concerns regarding their accounts.
  
• Performs various clerical duties such as photocopying forms, reports and patient information, typing letters, forms and labels, mailing and faxing forms, copying and filing; all requiring understanding and use of office equipment.

Supervisory Responsibilities       

                                                                                        

This job has no direct supervisory responsibilities.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Must be 18 years of age or older.

Education and/or Experience 

                                                                                             

High school diploma or general education degree (GED); and a minimum of 3 years work experience in outpatient clinic billing (Medi-Cal, HMO, PPO), preferably related to Pediatrics.  Certification in Coding/Billing preferred.  Bilingual in Spanish/English a plus.