The Medical Biller I is a full-time position responsible for the coding and billing of Medical, Dental, Optometry, Behavioral Health, OB-GYN, and Podiatry, claims. This position reports to the Billing Manager, in some cases, the focus may be on either coding or billing, but must be cross trained in both.

BENEFITS

• Free Medical, Dental & Vision
• 13 Paid Holidays PTO
• 403 (B) retirement match
• Life Insurance, EAP
• Tuition Reimbursement
• Flexible Spending Account
• Continued workforce development & training
• Succession plans & growth within

QUALIFICATIONS

Education and Experience

• Three (3) years of experience with revenue cycle operations management. With excellent presentation and writing skills. Advanced skills in analysis and MS Office suite. eClinical Works experience is preferred.
• High school diploma or GED required. Billing Certification required. 
• Demonstrated knowledge of all Insurance companies, HMO’s, PPO’s Government and State programs Medi-Cal and Medicare, and third-party payers.
• Experience with managing revenue cycle processes including Medicaid and Medi-Cal eligibility, health information management and billing, and charge capture processes.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Performs a combination, but not necessarily all, of the following duties:

• The billing department encompasses medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management.
• Works through patient insurance documentation, billing and collections, and data processing to ensure accurate billing and efficient account collection.
• Serves as a practice expert and go-to person for coding and billing questions and advice.
• Analyzes billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues.
• Follows up on claims using various systems, such as eClinical Works, Claim Remedi clearinghouse, Payer portals, etc.
• Maintains contacts with other departments to obtain and analyze patient information to document and process billings.
• Keeps up to date with carrier rule changes.
• Successfully scrubs and quality controls claims prior to submission.
• Works rejected claims and provides necessary follow-up to ensure successful claim processing.
• Maintains strong attention to detail and ability to multi-task.
• Maintains extremely high standards of professional conduct.
• Establishes and maintains effective working relationships with the office staff and Doctors.
• Adheres to policies regarding safety, confidentiality, and HIPAA guidelines.
• Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol and are in compliance with Federal, State, and payer regulations, guidelines, and requirements.