Full Time or Part Time Experienced Medicare Biller Needed. Must have minimum of 2 years experience billing Medicare claims. Preferably CAC Certified. This is an in-office position.

Position Summary

The Medicare, Medicare HMO and Contract biller is responsible for performing billing activities at the billing office related to Medicare Insurance and Contract claims including research, billing, follow-up, document process, appeals, and customer questions.

Specific Job Duties and Responsibilities

• Verify patient’s current information in database to ensure correct patient being billed to correct insurance source.
• Confirm eligibility of patient’s insurance coverage and payer as well as insurance ID # and coverage dates to bill to the proper payer resulting in accurate processing of the claim.
• Review ICD-10 codes to ensure accuracy resulting in compliance with Centers for Medicare & Medicaid Services regulations.
• Review rates for accurate billing for services rendered by emergency and non-emergency response personnel in order to remain in compliance with Medicare and Contract regulations.
• Mail 1500 insurance claim forms with attachments if needed, so claims are correctly routed and processed by insurance.
• Follow-up with Medicare and other insurances on outstanding claims so they are processed and paid correctly.

Medicare Biller

• Ensure patient’s Medicare MBI # and Medicare eligibility are valid and current to ensure billing Medicare with accurate information.
• Ensure Medicare is the primary insurance by utilizing online review sources. If Medicare is not primary and another insurance is primary to Medicare, reassign ticket to correct primary insurance biller.
• Validate patient's Medicare deductible standing in order to ensure proper, maximum reimbursement for claim.
• Follow Medicare Medical Necessity procedure to verify claims are billed for proper reimbursement
• Be aware of federally regulated time limits and submit Medicare claims in a timely manner.

Hospital Contract Biller

• Verify patient insurance information using online research tools to detect insurance source and patient ID #.
• Bill correct insurance source if it has been determined that the source will process a scheduled emergency or non-emergency claim for payment.
• Follow Contract Billing Policy to ensure claims are billed to the proper paysource based on Medical Necessity and Federal regulations.

What we are looking for in an employee

• Customer Service – Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits feedback to improve service; Responds to requests for service and assistance; Meets commitments.
• Interpersonal Skills – Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
• Teamwork – At work, on time and active participant to the team. Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed; Listens and responds constructively to other team members’ ideas; Offers support for others’ ideas and proposals; Is open with other team members about his/her concerns; Expresses disagreement constructively.
• Ethics – Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values.