Position Summary

The Medical Biller stationed at clinic will accurately expedite the claims process by creating claims for all daily generated superbills from assigned site(s). The Medical Biller will take all appropriate necessary measures to ensure proper reimbursement for all claims created. The Medical Biller will have knowledge of all insurance programs utilized at pertinent site.

Schedule:

Flexible, may require some evening and weekends

Primary Duties and Responsibilities

• Create claims by entering all superbills generated on a daily basis from assigned clinic site(s).
• Track missing, pending or incomplete superbills (e.g. Daily Superbills Report, retro, etc).
• QA superbills for accurate data entry (e.g. eligibility, payer, diagnosis, etc).
• Ensure completeness of claims for proper payment (e.g. PM160, CMS1500, attachments, etc)
• Interface with clinic staff and providers to obtain any required information needed to enter and bill/rebill a claim.
• Contact insurance vendors (e.g. eligibility, denials, etc)
• Organize superbills for storage (e.g. file, scan, label, etc)

Secondary Duties and Responsibilities

• Provide superbills or any attachment(s) requested (e.g. rebilling, HEDIS, superbills for audit etc)
• Generate/create various reports (e.g. Daily Superbill Report, go-backs etc)
• Assist in billing projects.
• Attend trainings, meeting, workshops, and webinars as needed.
• Will perform other related duties as assigned by the Billing Supervisor, Billing Manager, Controller, Finance Director or Executive Director.

Minimum Requirements

• Microsoft Office/Word/Excel/Outlook
• Excellent Communication Skills
• Excellent Customer Service Skills
• Knowledge of Medi/Cal reimbursement guidelines preferred
• Bi-lingual Spanish/English (preferred)
• Ability to work as a team player and work independently
• Reliable transportation
• Must be able to travel from facility to facility
• This position requires 10 % travel outside the local area.

Required Education/Experience and/or Licensure/Certification

• High school diploma or GED equivalent
• Certificate in medical billing
• Knowledge of HCPCS, CPT and ICD9
• Medical terminology
• Commitment to goals and philosophy of Northeast Community Clinic Valid State Identification

Physical Requirements and Working Conditions

• OSHA Category 3 Involves no regular exposure to blood, body fluids, or tissues, and tasks that involve exposure to blood, body fluids, or tissues are not a condition of employment.
• The work is majority of the time sedentary in nature.
• The employee is regularly required to communicate, frequently required to use repetitive motions, move, remain stationary, regularly push, pull and lift up to 20 pounds and occasionally push, pull and lift up to 40 pounds.
• Must possess mobility to work in a standard office/clinic setting (in some cases both settings) and to use standard office/clinic equipment, including a computer, stamina to maintain attention to detail despite interruptions, read printed materials and use a computer, and communicate in person and over the telephone.