Description

Salary: $21.00 - $23:00 / hour

The Medical Biller reviews electronic health records, encounters, computer generated reports, and other reporting tools to identify conditions treated and the services provided to each patient. Performs timely and accurate review of provider coding of diagnoses, services and procedures performed by physicians, physician assistants, nurse practitioners, and any other provider performing billable services, and verifies or recommends appropriate changes utilizing the appropriate coding system including ICD-9-CM and ICD-10, CPT-4 and HCPCS codes. This person will support CHP's mission, vision, and values and will adhere to compliance protocols as well as CHP's policies and procedures.

Position Requirements

Medical Biller Essential Duties and Responsibilities:

Reviews Athena bucket, encounter, computer generated reports and other reporting tools to identify all services and procedures performed by physicians, physician assistants, nurse practitioners, and any other provider performing billable services.

Reviews appropriate CPT-4 and HCPCS Level II codes.

Reviews appropriate ICD-9-CM (ICD-10) diagnosis codes verifying and/or recommending the codes that accurately describe the condition for which the service or procedure was performed.

Obtains and submits copies of medical documentation as required or requested by third party payers.

Analyzes and resolves claim rejections and denials related to coding or other issues.

Identifies trends and ongoing problems related to medical documentation and recommends possible solutions to the Billing Team.

Answers patient questions, identifies and resolves patient billing complaints.

With the billing team follows and reports status of delinquent accounts.

With the billing team evaluate patient financial status and establish payment plans as instructed.

Other duties as requested by supervisor.

Competencies: To perform the job successfully, an individual should demonstrate the following competencies:

Strong ability to multi-task.

Customer Service - Manages difficult or emotional client/patient situations.

Responds promptly to patient needs.

Solicits customer feedback to improve service.

Responds to requests for service and assistance.

Meets commitments and is punctual.

Follows policies and procedures.

Completes administrative tasks correctly and on time.

Supports organization's goals and values.

Flexible: Willing to step in when needed and crossed trained for additional administration/billing support.

Maintains confidentiality.

Keeps emotions under control.

Professional, welcoming personality.

Contributes to building a positive team spirit.

Responds well to questions.

Takes careful and accurate notes.

Follows up on messages and ensures delivery of messages.

Composes/types letters if requested by administration.

Essential Skills and Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

High school diploma or GED or Associates Degree in Business.

At least one year of billing experience in a medical office.

Must successfully complete internal proficiency examination.

Must have knowledge of physician specialty billing (e.g., family practice, OBGYN, Internal Medicine, Pediatrics).

Have knowledge of Medicare and Medicaid billing regulations.

Knowledge of medical terminology, anatomy and physiology.

Knowledge of ICD-10, CPT-4, HCPCS and modifier usage.

Knowledge of third party payer reimbursement policies and procedures.

Ability to operate computer, other office equipment, and set this up for home use.

Knowledge of coding and billing programs and ability to use coding and claims software.

Knowledge of EHR with experience with Athena a plus.

knowledge of billing for a Federally Qualified Health Center (FQHC)

Spanish speaking/bilingual skills are a plus.

Have access to secure home internet and secure space to work within the home space.

Full-Time/Part-Time
Full-Time

Position
Medical Billing Specialist

Exempt/Non-Exempt
Non-Exempt

Location
CHP Administrative Offices

EOE Statement
We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.