Description

Job Purpose

The Biller is responsible for WCNF EDI charge capture and claim submission.

Duties and Responsibilities

• Reviews referrals to ensure that all charges for each date of service have been captured. 
• Where appropriate, completes charge corrections into billing system based off office documentation. 
• Meets and maintains daily productivity and quality standards established in departmental policies. 
• Adheres to the policies and procedures established for the client/team. 
• Verify and ensure that the patients demographics are properly entered in the host system, correcting errors when necessary and verifying that proper authorizations are entered.
• Perform special projects and other duties as needed. 
• Ability to analyze, identify and resolve issues which may be causing payer payment delays 
• Act cooperatively and courteously with patients, visitors, co-workers, management and clients. 
• Maintain confidentiality at all times.
• Maintain a professional attitude. 
• Other duties as assigned by the management team. 
• Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

Requirements

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: ICD-10, CPT, and HCPC codes, LCD guidelines, rejections, clearinghouse, as well as 1500 forms
• Knowledge of various types of insurance plans, CPT, ICD-10, billing guidelines
• Ability to work well individually and in a team environment
• Strong communication skills/oral and written 
• Strong organizational skills, with a strong attention to detail

Working Conditions

• 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.