BILLER

Responsibilities:

Position Summary:

The Biller is responsible for the accurate and timely submission and follow-up of Managed Care and Commercial insurance claims for the Psychiatric Division. This role includes oversight of claim transmissions, follow-up with third-party payers, account reconciliation, and patient billing inquiries. The Biller ensures compliance with all regulatory billing guidelines and supports revenue cycle efficiency through accurate documentation and proactive follow-up.

Key Responsibilities:

• Submit and follow up on all Managed Care and Commercial insurance claims for psychiatric services.
• Monitor daily transmittal, acceptance, and error reports to ensure accuracy and timeliness of electronically submitted claims.
• Correct and resubmit claims via EMR or other claim correction tools as required.
• Manually submit all secondary insurance claims that do not transmit electronically after Medicare payment.
• Follow up with secondary third-party payers to confirm claim receipt and obtain status updates.
• Process refunds as necessary, ensuring accuracy and documentation.
• Respond professionally to patient billing inquiries in a timely and courteous manner.
• Maintain accurate and up-to-date records and documentation, including patient folders and remittance advices.
• Review and reconcile patient accounts following Managed Care and Commercial insurance claims payments.
• Verify that clinical summaries align with billing details to ensure accurate claims submission.
• Review and follow up on items listed in the monthly Aged Trial Balance.
• Maintain and update the Bad Debt Log in accordance with department procedures.
• Bill secondary self-pay accounts to patients through the full dunning cycle.
• Ensure that all financial information in patient folders is complete and accurate upon check-in from the division.
• Assist in other related or emergency duties as assigned by supervisor or leadership.
• Support the billing department in achieving overall compliance and performance goals.

Qualifications:

• High School Diploma or GED required; Associate’s degree in Accounting, Business, or Healthcare Administration preferred.
• Minimum 2 years of medical billing experience, preferably in a psychiatric or behavioral health setting.