Medical Biller in Philadelphia, PA at Public Health Management Corporation

Date Posted: 11/30/2020

Job Snapshot

Job Description

Under the general supervision of the Billing Supervisor, the Medical/Behavioral Health Biller is primarily responsible for checking eligibility and benefits, obtaining pre-authorizations, preparing and transmitting claims, posting payments, and following up on any unpaid claims or denials.

Responsibilities:

  • Checking eligibility and benefits verification for treatments and procedures
  • Obtaining pre-authorizations as required
  • Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing
  • Reviewing patient bills for accuracy, completeness and obtain any missing information
  • Identifying and billing secondary or tertiary insurances
  • Checking each insurance payment for accuracy and compliance with contract discount
  • Following up on unpaid claims within standard billing cycle timeframe
  • Calling insurance companies regarding any discrepancy in payments if necessary
  • Researching and appealing denied claims
  • Post and reconcile payments against the EOBs
  • Ensure accuracy of insurance tables in the EHR
  • Report overdue balances and collections
  • Send monthly statements
  • Update patient accounts
  • Answering all patient or insurance telephone inquiries pertaining to assigned accounts
  • Setting up patient payment plans and work collection accounts
  • Updating cash spreadsheets and running collection reports

Skills:

  • Knowledge of processing claims on UB-04 and HCFA 1500 forms
  • Knowledge of CPT & ICD-10 coding
  • Must have working knowledge of medical and behavioral health terminology
  • Excellent interpersonal, verbal, and written communication skills.
  • Strong problem-solving skills.
  • Demonstrate ability to work independently and to organize and prioritize work.
  • Knowledge in utilizing the various insurance portals.

Experience:

  • Minimum of 3-5 years of experience working as a medical/behavioral health biller, preferably in an outpatient setting. Experience with Medicaid, Medicare and other government insurance. CPC or other professional certification preferred.

Education Requirement:

  • High School Graduate or equivalent

Salary:

  • Commensurate with education and experience

FLSA Classification: Non-Exempt

  • This position is classified as salaried non-exempt in accordance to FLSA standards.