Full-Time Biller/Collector

Department: Business Office

Reports To: Business Office Manager

JOB SUMMARY

This biller/collector is responsible for electronically transmitting and follow-up on all medical claims as assigned, including any secondary insurance claims.  Duties also include the examining of EOBs and taking steps to move the accounts to resolution.  It is necessary to understand billing laws and guidelines, computer programs for electronic transmission, and other billing practices. The billing / collector will interact with patients, therefore, it is vital that the biller / collector is pleasant, easy to work with, and is willing to build rapport with patients. Will act as an advocate for hospital programs and adheres’ to the hospital Mission, Vision, Values and Motto of “The Patient is First in All We Do”.

ESSENTIAL DUTIES

  • Editing and correcting the billing information prior to transmission/submission of the claims. 
  • Reviewing EOBs and ERAs that have been posted.  
  • Posting of cash / insurance payments and adjustments form EOBs and other remittance.
  • Advices to patient accounts with special attention to the EOB for denials or improper write-offs by an insurance company. I proper write-offs will be brought to the attention of the appropriate person for follow-up action.
  • Verifying information and taking appropriate action to move the account toward resolution. 
  • Calling payers for claim status, questions and appeals as needed.  Submitting formal appeals on denied claims as needed.
  • Monitoring the accounts on the Information System to resolve processing problems and to meet goals related account aging and cash collected.  Meeting goals will be rewarded.
  • Staying up to date on billing guidelines and regulations related to payers.   
  • Working credit balances, refunds, and any other issues within assigned accounts.
  • Teamwork and respect for co-workers is required.  A customer-service attitude toward patients, other employees and outside organizations is expected.
  • Back-up admissions, answering phones, customer service, filing and other duties as assigned.
  • Co-admitter with responsibilities for all aspects of the admitting position.
  • Sorts and files records.
  • Answers telephone, conveys messages.
  • Stamps, sorts, and distributes mail.
  • Photocopies documents.
  • Completes compliance training
  • Demonstrates a spirit of cooperation and enthusiasm to create a team atmosphere conducive to self-improvement and agency growth. Performs other duties as assigned by the home care director, participating in specialty teams and agency programs.
  • Demonstrates patience and tact when dealing with patients, family and other staff members, conveying a sense of caring and dignity.
  • Demonstrates a sense of responsibility and moral integrity, acting as self-starter who works independently and who consistently finds ways to improve their own job and hospital operations as part of the health care team.
  • Assumes responsibility for knowing agency policy and expectations.
  • Must comply with HIPPA and keep home care / hospital confidentiality.
  • Must attend yearly OSHA training and yearly flu vaccination.

QUALIFICATIONS

Required Job Qualifications include:

  • Must be a High School Graduate.
  • Experience with office work including typing, computers and office equipment.
  • Medical billing experience preferred, but general office experience, with a good understanding of office functions is required.
  • Knowledge of billing and collection preferred.

PHYSICAL DEMANDS/REQUIREMENTS

While performing the duties of this position, the employee is required to carry, climb, hear/listen, lift, reach and manipulate objects, tools, or equipment, push/pull, see, speak, squat/kneel, stand, and walk.  Position requires moving materials weighing 10 – 20 pounds, and 25 – 50 pounds on an occasional basis.  Manual dexterity and coordination are required over 80% of the work period.  Work involves the potential for exposure to infection.  The employee is occasionally exposed to outside weather conditions. The noise level in the work environment is usually moderate.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above 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.

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