1 Medical Claims Biller I Job in Merced, CA

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Medical Claims Biller I

Riggs Ambulance Service

Merced, CA | Full Time

$43k-51k (estimate)

7 Months Ago

Medical Claims Biller I

$43k-51k (estimate)

Full Time | Ancillary Healthcare 7 Months Ago

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Riggs Ambulance Service is Hiring a Medical Claims Biller I Near Merced, CA

JOB TITLE: MEDICAL CLAIMS BILLER

REPORTS TO: BILLING OFFICE LEAD/BILLING OFFICE DIRECTOR

Rate of pay/Salary : 33,280.00 annual salary/ DOE

BASIC FUNCTION: Performs a variety of functions within the billing process that includes statements, correspondence, refunds, denials, rebills, collections & customer service. Prepares medical claims for electronic & paper submission to patients, insurance companies, Medicare, Medi-Cal and other financially responsible payors. Facilitates a fluid process of billing claims in a timely & successful manner.

RESPONSIBILITIES:

Review & ensure that the charts & claims are in compliance with federal, state, legal & insurance guidelines, requesting addendums as needed
Analyze & code EMS procedures & diagnosis using ICD-10 & HCPC codes
Verify patient payor sources for services & maintain payor information in the billing software
Enter all ticket information into billing system in an accurate & timely manner
Prepare & submit electronic & paper claims within established cycle & month-end deadlines
Use work flows regularly to insure all pending/denied/underpaid claims are processed within designated time frames
Process denials/underpayments/overpayments & search for supporting documentation to support claim appeals and follow up as directed.
Respond to patient/payor inquiries regarding claims
Attend training seminars & conferences as requested
Cross train/assist in other billing specialty areas as required by management
Establish a good rapport and professional working relationship with all departments & readily assist coworkers
Follow all company policies & procedures related to HIPAA regulations, patient privacy & protected health information

QUALIFICATIONS:

Knowledge of commonly used concepts, practices & procedures of the medical billing industry
Proficient in typing, word processing, Microsoft Outlook & billing software
Ability to work independently, follow directions, set priorities, meet deadlines & adapt to change
Good organization/communication/customer service skills
Must be able to read, write and understand the English language.

PHYSICAL REQUIREMENTS:

Requires routine walking, standing, bending, reaching, squatting, lifting and carrying items weighing less than 40 pounds. Requires working at computer workstation for extended periods.

JOB RESPONSIBILITIES RELATED TO PATIENT PRIVACY

The incumbent is expected to protect the privacy of all patient information in accordance with the Company’s privacy policies, procedures, and practices, as required by federal law, an in accordance with general principles of professionalism as a health care provider. Failure to comply with the Company’s policies and procedures on patient privacy may result in disciplinary action up to and including termination of employment.

The incumbent may access protected health information (PHI) and other patient information only to the extent that is necessary to complete your job duties. The incumbent may only share such information with those who have a need to know specific patient information you have in you possession to complete their job responsibilities related to treatment, payment or other company operations.

The incumbent is encouraged and expected to report, without the threat of retaliation, any concerns regarding the Company’s policies and procedures on patient privacy and any observed practices in violation of that policy to the designated Privacy Officer.

The incumbent is expected to actively participate in Company privacy training and is required to communicate privacy policy information to coworkers, students, patients and others in accordance with Company policy.

PROTECTED HEALTH INFORAMTION ROLE BASED ACCESS

Access to PHI will be limited to those who need access to PHI to carry out their duties. The following describes the specific categories or types of PHI specific to this job description: