Physician Biller - Billing Office

Job Category
:
Admin/Clerical

Requisition Number
: PHYSI
012792

• Full-Time
• On-site

Showing 1 location

Supports, and is responsible for incorporating into job performance, the Frederick Health (FH) mission, vision, core values and customer service philosophy and adheres to the FH Compliance Program, including following all regulatory requirements and the FH Standards of Behavior.

The Physician Billing Representative is responsible for ensuring that patient charges and payments are correct on the patient account, insurance authorization has been obtained, timely submission of the account and timely follow up to achieve payment from third party payer or the patient. S/he demonstrates a high level of accuracy considering the volume and filing requirements of the various insurance payers;

and recognizes the priorities of the work to be completed in order to maximize efficiency.

• Correct Availity Registration edits
• Run denials reports daily and correct claims or appeal where necessary
• Attach EOBs to secondary paper claims and submit for payment
• Attach referrals to claims and reprocess to carrier
• Print and send medical records with claims
• Key Medicaid claims for payment claims
• Patient and Insurance Correspondence
• Credit management
• Verify insurance eligibility and claim status
• Review exception batches for distribution
• Electronic payment and denial posting
• Posting of $0 balance remits
• Reconciliation of Daily Batches
• Posting of daily payment batches
• Reconciliation of Daily office cash deposits

• Knowledge of medical terminology, anatomy and physiology, pharmacology and disease processes
• Demonstrated competency with medical procedural coding (CPT/ICD
  10)
• Demonstrated competence with patient or customer information systems
• Intermediate proficiency and accuracy in the use of software programs such as MS Word, Excel, PowerPoint, ACCESS and Outlook
• Excellent communication skills, both verbal and written
• Ability to work in a fast paced environment
• Strong organizational skills and ability to prioritize and manage multiple tasks
• Ability to communicate information and ideas in speaking so others will understand
• Ability to understand written sentences and paragraphs in work related documents
• Ability to work professionally with a diverse population base
• Ability to maintain a high level of confidentiality
• Ability to create, compose and edit written materials
• Ability to analyze and solve problems.

• High School Diploma or GED required. Associate’s degree in business administration, or related field preferred.
• College courses in CPT and ICD-10 coding preferred.
• Minimum of two (2) years prior physician billing experience with demonstrated working knowledge of professional fee billing transactions and regulations, claims, insurance carriers, rejection and denial codes, error correction and re-posting and contractual adjustments.

Must demonstrate and maintain current knowledge and skills in providing appropriate care/contact for patients in the following age groups:

_xPerformance of job does not require patient contact

Sedentary
- Light Work
- Lifting up to 15 pounds on an infrequent basis (less than one lift every three minutes). While work is mostly done sitting, a certain amount of walking or standing is often necessary.

Repetition:
Repeating the same motion over and over again places stress on the muscles and tendons. The severity of risk depends on how often the action is repeated, the speed of the movement, the required force and muscles involved.

Awkward Posture:
Posture is the position your body is in and its effect on the muscle groups that are involved in the physical activity. Awkward postures include repeated or prolonged reaching, twisting, bending, kneeling, squatting, working overhead with your hands or arms, or holding fixed positions.

A. Bloodborne Pathogens Exposure Risk:
Category C – NO exposure to blood or body fluids.

Reports to Manager, Physician PFS

Frederick Health offers a comprehensive and affordable benefits package. Health, Dental and Vision insurance are offered the 1st of the month after 30 days of employment to all employees hired to work at least 20 hours per week and we offer…