Medical Biller II
Affiliate Wide - Revenue Cycle
Job Type
Full-time
Description
Medical Biller II Affiliate Wide
Planned Parenthood of Central and Western New York (PPCWNY) protects and provides health care and education that empowers individuals and families. With respect. Without judgment.?No matter what.
In support of PPCWNY's mission, the Medical Biller II has the overall responsibility to ensure effective billing and collections on all patient accounts.
Essential Functions
Reviews all Tasks assigned to the individual/workgroup.
Aggressively follows up on all unpaid accounts to ensure that the A/R benchmark targets are met or exceeded.
Answers patient calls and address questions related to insurance and patient responsibility.
Works in conjunction with other staff to successfully meet internal goals.
Performs all duties in accordance with established agency policies, protocol and the In This Together services ethos, workplace values, and service standards.
Notifies Billing Manager of any collection or workflow issues.
Shows respect to all internal and external customers for differences in backgrounds, lifestyles, viewpoints and needs
Insurance Tasks:
Runs assigned reports to review all unbilled patient transactions for accuracy and completeness of charges and appropriateness of coding, correcting errors as needed
Verifies Insurance coverage to make sure coverage is effective for the billable date(s), appropriate for the services provided and all policy details are entered accurately
Addresses any claim edits that occur prior to filing claims, or that are a result of creating claims
Files clean claims electronically and on paper when necessary, using the NextGen EPM system or any other practice management systems clients are utilizing, and various clearinghouse applications as applicable
Posts payments from insurance companies
Applies payments and adjustments accurately from the remittance
Reviews to make sure that the charges roll appropriately to the next responsible party
Makes eligible sliding fee adjustments
Makes sure the batch balances
Maintains awareness of contracted reimbursement rates, follows up on discrepancies and notifies supervisory when there are unresolved issues
Works rejected claims and denials received on remittances
Performs timely follow up on outstanding unpaid claims; resubmits or appeals claims as needed in accordance with payer requirements
Patient Billing and Cash Application:
Works credit balances on a timely basis to ensure overpayments are addressed
Makes follow-up phone calls and sends past due letters on accounts with outstanding balances according to patient collections policies and procedures
Reviews accuracy of patient accounts prior to generating statements
Processes patient payments, returned checks, small balance write-offs and bad debt adjustments in accordance with established policies and procedures
Other Accountability Activities
Attends and participates in team meetings and other required meetings or training opportunities including education on insurance rules and regulations
Assists with training of other staff
Participates in affiliate initiatives
Performs other duties as assigned by the Billing Manager
Builds and maintains positive, quality relationships with customers, both internal and external
Adheres to PPCWNY safety and security rules, policies, and procedures and HIPAA confidentiality standards
Requirements
Qualifications
Applicants must possess the following qualifications (or equivalent combination of education and experience):
Education
Associate's degree in business, accounting, business administration, or a related field or equivalent combination of education and experience
Experience
Minimum three years of experience in medical billing/collections
Minimum three years of experience with computerized billing/receivables system and reports
Experience with NextGen practice management system preferred
Certifications
Ideal candidate will have one of the following certifications but is not required: Registered Health Information Administrator (RHIA), Certified Health Information Technician (CHIT), Certified Coding Specialist (CCS), Certified Medical Billing Specialist (CMBS), or Certified Professional Coder (CPC)
Knowledge, Skills, & Abilities
Minimum three years of experience in medical billing/collections
Minimum three years of experience with computerized billing/receivables system and reports
Experience with NextGen practice management system preferred
Must be sensitive to patient's financial and clinical needs while maintaining the patient's confidentiality
Experience in insurance guidelines and programs (i.e., Medicaid and Medicare)
Knowledge of ICD-9/10, HCPCS and CPT codes
Extensive experience with follow-up on unpaid claims within standard billing cycle timeframes
Extensive experience with appealing insurance companies for denied claims
ERA payment posting experience
Must be able to multi-task and work in a fast-paced environment effectively under deadlines
Accuracy and attention to detail is essential
Extensive experience in researching issues and providing resolutions
Strong analytical and problem-solving skills
Must be able to work independently and as a team player
In-depth knowledge of Government and non-Government payer sources
Experience working with databases and Microsoft Office (i.e., Excel and Word)
Ability to work a flexible schedule (i.e., early mornings and evenings)
Must have top-notch customer service and follow-up skills
Ability to read and interpret medical procedures and terminology
Planned Parenthood seeks candidates who are proficient in two or more languages
Working Conditions
Standard office environment
May experience visual fatigue working at computer with potential extended periods of sitting
Well-lit/ventilated
Physical Requirements
Ability to lift 10 pounds with or without an accommodation
Possess sufficient mobility to perform the Essential Functions listed in this Job Description with or without an accommodation
Ability to travel to all agency locations and donor/prospect locations as assigned
Work Schedule This is a full-time (40 hours per week) position; regular schedule will be Monday - Friday with occasional evenings and weekends. Benefits & Compensation At PPCWNY, we are committed to equitable compensation practices and transparency. ?In alignment with these efforts, the pay for this position ranges from $21.89 - $25.36/hr. Actual compensation will be determined by experience and other factors permitted by law. In addition to competitive compensation, PPCWNY offers an extensive benefits package with generous Paid Time Off, 10 paid holidays, affordable medical, dental, and vision options, Health Savings Account or Flexible Spending Account, 401(k) with match, and much more!
Planned Parenthood of Central and Western New York is an equal opportunity employer.
Salary Description
$21.89 - $25.36
