The Biller is responsible for WCNF EDI charge capture and claim submission.
Duties & Responsibilities
Review referrals to ensure that all charges for each date of service have been captured
Complete charge corrections into billing system based off office documentation
Meet and maintain daily productivity and quality standards established in departmental policies
Adhere to the policies and procedures established for the client/team
Verify and ensure that patient demographics are properly entered in the host system, correcting errors when necessary and verifying that proper authorizations are entered
Analyze, identify and resolve issues which may be causing payer payment delays
Maintain confidentiality and a professional attitude at all times
Other duties as assigned
Use, protect and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
Understand and comply with Information Security and HIPAA policies and procedures at all times
Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties
Qualifications
High school diploma or equivalent required
Previous experience in Hospital/Facility or Physician billing: preferred
Experience with EPIC preferred
Basic knowledge of healthcare claims submissions and processing including
Knowledge of various types of insurance plans, CPT, ICD-10, billing guidelines
Proficiency in Microsoft Office Suite
Strong interpersonal skills, ability to communicate well at all levels of the organization
Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
High level of integrity and dependability with a strong sense of urgency and results oriented
Excellent written and verbal communication skills required
Working Conditions
Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes
Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear
Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress
Work Environment: The noise level in the work environment is usually minimal
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.
Numbers & Facts
Location
Melville, NY
Skills
Analysis Skillsunmatched
Authenticationunmatched
Billingunmatched
Charge Captureunmatched
Claims Processingunmatched
Communication Skillsunmatched
Current Procedural Terminology (CPT)unmatched
Documentationunmatched
Electronic Data Interchange (EDI)unmatched
Geneticsunmatched
HIPAA (Health Insurance Portability and Accountability Act)unmatched
Healthcareunmatched
High School Diplomaunmatched
Hospitalunmatched
ICD-10unmatched
Identify Issuesunmatched
Information/Data Security (InfoSec)unmatched
Insuranceunmatched
Interpersonal Skillsunmatched
Medical Billingunmatched
Medical Recordsunmatched
Microsoft Officeunmatched
Militaryunmatched
Office Equipmentunmatched
Peripheral Hardwareunmatched
Policy Developmentunmatched
Presentation/Verbal Skillsunmatched
Problem Solving Skillsunmatched
Procedure Developmentunmatched
Quality Metricsunmatched
Security Complianceunmatched
Smartphonesunmatched
State Laws and Regulationsunmatched
Time Managementunmatched
Writing Skillsunmatched
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