Medical Biller I - Los Angeles, United States - St Johns Community Health

St Johns Community Health
St Johns Community Health
Verified Company
Los Angeles, United States

6 days ago

Mark Lane

Posted by:

Mark Lane

beBee recruiter
Description

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 thirdparty 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 goto 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 followup to ensure successful claim processing.
  • Maintains strong attention to detail and ability to multitask.
  • 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.
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