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SR. MEDICAL BILLER

HEALTHCARE

SR. MEDICAL BILLER

Option 1 Staffing is an award winning, local, recognized leader in staffing and recruiting, specializing in placing the highest caliber of Non-Clinical Healthcare, Information Technology, Supply Chain, Administrative/Office and Accounting/Finance professionals in contract and direct-hire opportunities. We work with top and emerging companies in the Technology and Healthcare industry.

POSITION SUMMARY:

The Sr. Medical Biller serves as the department expert in regards to all billing that is processed for the assigned area. Duties include: ensuring charge entry and coding is correct, submitting claims via billing system daily, verifying insurance coverage and client co-payments and obtaining authorizations for treatment from the clients’ insurance pay source. Reviews accounts to determine cause of non-payment and contacts insurance carriers, patients or guarantors at established intervals to follow-up on status of delinquent accounts, determines the reason of delay and expedites payment. Initiates re-billing of third-party payors when applicable. Identifies and initiates corrective action. The Senior Medical Biller provides guidance to billing staff; resolves unsettled items and assists in the recovery of underpayments and denials relative to patients’ accounts and third-party payers. Works with billing staff to ensure informational data is accurate and timely, optimizing revenue and maximum cash flow benefit to the clinics.

ESSENTIAL RESPONSIBILITIES / DUTIES:

  • Collects all necessary information for proper charge entry and billing; reconciles dollar amounts on batch reports; adds diagnosis codes or corrects missing/incorrect elements to submit electronic billing (invoicing).
  • Performs follow-up with insurance companies, workers compensation payers, other third-party payers, medical groups, outside hospitals, and physician’s offices to ensure timely payments of patient bills in accordance with the terms and conditions of each contract and/or insurance company policies.
  • Follow up with clinics, patients and/or third-party payers to correct errors, obtain missing information, verify referral authorizations, and appeal denied payments.
  • Collects and reconciles payments (from self-pays or third-party payers) on overdue accounts. Ensures that payers adhere to compliance laws regarding timely processing of claims.
  • Reviews accounts to determine cause of non-payment and contacts insurance carriers, patients or guarantors at established intervals to follow-up on status of delinquent accounts, determines the reason of delay and expedites payment. Initiates re-billing of third-party payors when applicable.
  • Assists manager with auditing accounts. Provides direction and guidance to billing staff by sharing techniques and knowledge and by providing solutions to billing issues.
  • Researches and documents any questionable item causing the denial or underpayment of claims and makes efforts to appeal, re-bill or seek solutions for future improvements.
  • Recommends process changes which would resolve re-occurring billing problems, streamline the billing process, decrease the number of retrospective authorizations, enhance patient satisfaction, and maximize cash flow to the clinics.
  • Identifies and reports to manager billing process or system issues. This includes solving problems with third-party billing agencies, or dealing with electronic transmission or software system issues of third-party payers.
  • Performs routine administrative work such as charge entry, handling forms, posting payments & remits, filing, photocopying, faxing, mailing, etc.
  • Conforms to hospital standards of performance and conduct, including those pertaining to patient rights, so that the best possible customer service and patient care may be provided.

EDUCATION:

HS/GED plus 2 + years healthcare experience

EXPERIENCE:

Experience as noted in the education requirement section above, of which at least 2 years are in a medical billing capacity

KNOWLEDGE AND SKILLS:

  • Requires comprehensive knowledge of all procedures, systems, and equipment used as well as a high level of proficiency in data entry, data control, and scheduling and processing of batch work at a level generally acquired during two to three years medical billing experience.

Requires ability to maintain cooperative working relationships with department personnel, including staff and physicians, and outside personnel including patients and third-party payors.

We Offer:

  • Excellent opportunity to work for a outstanding, large and growing company!
  • Renown Healthcare Organization – Huge career growth potential!
  • Awesome Benefits!
  • Excellent salary!
  • Medical Insurance
  • 401K

For immediate consideration, please apply!

“Best of Staffing Award”

Best of Staffing Award is the only award in the U.S that recognizes staffing agencies that have proven superior service quality based entirely on ratings provided by their clients and job candidates. Award winners make up less than 2% of all staffing agencies in North America.

“Top Performer Award”

Top Performer Award by Workforce Logic highlights high-performing staffing companies who are chosen based on a variety of criteria critical to our clients’ satisfaction, including customers serviced, cycle time, submittals per requisition, percentage of submittals hired, program compliance, fill ratio, and more.

Member American Staffing Association Since 1991.

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