Medical Biller- Orthopedics

Tri- Valley Orthopedic Specialists, a Division of Bass Medical Group is a full comprehensive, multi-specialty, state-of-the-art orthopedic practice providing high level services to the community in Pleasanton, San Ramon and Tracy with X-ray, MRI, ultrasound, Ortho Tech department, DME, Physical and Occupational Therapy on site.

We are seeking a qualified and dedicated Medical Biller to join our team. In this position, you will be responsible for a variety of tasks requiring knowledge of CPT and ICD 10 codes, accounts receivables, claims appeals, understanding clinical and surgical notes, data analysis, in-depth evaluation, patient AR/collections, and sound judgment.

To succeed in this role, you must possess in-depth knowledge of Revenue Cycle Customer Billing, CPT and ICD 10 codes, billing software and medical insurance policies. The ideal candidate must also be able to demonstrate excellent written and verbal communication skills, as communicating with patients and various insurance carriers will form a large part of the job.

MAJOR DUTIES AND RESPONSIBILITIES:
Primary Functions:

• Worklist claims box- review clinical and surgical documentation to capture accurate billing codes using CPT/HCPS and ICD-10, respond to requests from the billing entities,
• Working knowledge of billing, insurance and interpreting EOB’s is mandatory.
• Ensure the patient’s medical information is accurate and up to date including valid authorizations for each claim,
• Account resolution via communications with Privia Health billing teams, patients and insurance companies,
• Investigate and request an appeal through Privia for denied claims,
• Incoming billing inquiries,
• Processing rebills, appeals & correspondence,
• Managing aging and monthly reports,
• Submit employer profile updates and information as necessary,
• Keeps management informed of areas of concern and problems identified,
• All other duties, as assigned,
• Follows all HIPAA guidelines.

A/R Aging Report

• Outgoing calls to patients, insurance companies, etc.
• Adjustments are applied when appropriate
• Communicate with the Privia billing team for any errors, claim holds, etc
• Patient AR phone calls, notices and collections.

Documentation

• Document notes into billing system
• Request documentation from clinics to support charges
• Address correspondence and customer requests
• Generate rebills for open balances
• Correct insurance information and redirect bills to appropriate payor
• Update employer changes and re-submit corrected bills

WORKING CONDITIONS/PHYSICAL DEMANDS:

• Monday- Friday 8:00 am- 5:00 pm
• Office environment
• Sitting for extended periods of time
• Heavy telephone work.

Required Skills
JOB-RELATED SKILLS/COMPETENCIES:

• Excellent communication and organizational skills
• Problem solving skills and ability to handle multiple tasks
• Excellent writing and documentation skills required
• At least 2 years medical collection experience
• Ability to work independently
• Requires outstanding customer service skills and excellent problem solving skills
• Ability to assist peers and train new employees.
• Consistently meets or exceeds pre established goals
• Ability to be flexible and willing to work multiple systems if requested
• Bilingual a plus
• Experience in Orthopedics, Spine and Podiatry a plus
• Knowledge of Athena EMR system a plus
• Certified coder a plus

Job Type: Full-time

Pay: From $23.00 per hour

Application Question(s):

• Wage expectation

Education:

• Associate (Preferred)

Experience:

• Medical Coding and billing: 3 years (Required)

Language:

• Spanish (Required)

Work Location: In person

Salary : $23