Description

Under direct supervision, the Insurance Biller is responsible for all aspects of paper and electronic billing as well as collections activities including reviewing and auditing codes and verifying insurance..

Core Competencies

Reviews claim scrubber and resolves claim edits. Maintains payor-related items, such as EFTs and Payor IDs for 835s. Verifies insurance eligibility and authorization. Works monthly aging of PPO's, Medicare, HMO's, cash and Workers Compensation. Documents detailed notes including action items taken, when appropriate. Responds timely and accurately to all incoming correspondence and inquiries from payers, patients and other departments. Reviews reports to identify denials from Medicare, PPOs, Worker Compensation, Commercial and Contracted carriers; corrects and resubmits claims using accurate ICD-9,ICD-10 and CPT codes; suggests action plans to eliminate denials in the future. Elevates issues as appropriate to Supervisor. Assists with orientation and training of new employees/ volunteers, as assigned.