G247
Located in Coquille, OR
Pay: $21-$37
Job Full Description
Medical Biller
Schedule-Mon-Fri, 8:30am-5pm
Pay- $21.00- $37.00hr
Temp with the potential for perm.
Purpose/Description-
- The Medical Coder-Biller is responsible for entering ICD and CPT diagnostic and procedural codes for a variety of services including inpatient, ancillary, outpatient, physician offices, emergency room, behavioral health, and ambulatory care. Ensures accurate and timely billing and follow-up collection of all assigned accounts. Ensures proper submission and adjudication of all claims submitted to third-party carriers/intermediaries and timely response to all inquiries according to policy and procedures.
Duties and Responsibilities-
Essential Duties:
- Responsible for reviewing documentation to make sure the documentation supports the levels or types of service billed/or assign level service based on documentation.
- Potential to provide physician education on billing practices.
- Provides feedback to management regarding any issues or repetitive errors that may be encountered during claim review and submission.
- Completes follow-up of claims on a timely basis according to the productivity guidelines for accounting follow-up goals.
- Reviews system-generated worklist, reports, and/or aged trial balances to resolve accounts that have not been paid in the appropriate time frame, based on specific third-party payer contracts and guidelines.
- Contacts assigned payer representatives to determine when payment will be made and if other information is required to adjudicate a claim.
- Reviews payment denials and discrepancies identified through Explanation of Benefits, Remittance Advices, or payer correspondence and takes appropriate actions to correct these accounts.
- Documents account for activities in an accurate and timely manner in accordance with PFS quality standards.
- Applies a high level of knowledge of the respective insurance billing regulations and guidelines. Research into these guidelines when required on payer websites where available.
- Ensures compliance with all state and federal billing regulations and reports suspected compliance issues to their respective Leads/Supervisors/Managers.
- Conducts inquiries via telephone, mail, and fax, or electronically through payer websites or e-mail for follow-up of unresolved accounts.
- Contacts patients with additional information to ensure claims are processed and paid.
- Works with various departments throughout to obtain additional information for the billing and follow-up process. Works with management and PFS staff to improve processes, increase accuracy, create efficiencies and achieve the overall goals of the department.
- Maintains proficiency and levels of knowledge with all systems required for task completion.
- Attends required training and completed online training and surveys as required.
- Attends meetings with payer representatives and/or vendors to address outstanding issues and learn about new regulations and guidelines.
- Reviews and analyzes patient issues to fully understand the patient’s concern. Forwards or routes patient calls or concerns when required to an appropriate Patient Accounts Services resource for assistance
- Prepares appeal letters and reconsiderations both on paper and online, in a professional and factual manner resulting in claim adjudication.
- Other duties as assigned.
Roseburg, OR
2106
741 Northeast Garden Valley Boulevard
Roseburg, OR 97470
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