701 W.
Center Ave.
, Visalia, CA 93291
Identification Section
Position Title: Medical Biller
Department: Corporate EEOC Class: SW
Reports To: Billing Manager FLSA Status: Non-exempt
General Summary
Responsible for preparing, reviewing and submitting claims to various payers either electronically or paper.
Responsible for following up on unpaid claims, denials and rejections utilizing daily and monthly reports.
Essential Job Functions
Review and transmit claims using billing software, including electronic and paper claim processing, determine problem that resulted in a rejected claim, resolve, advise on procedural changes to implement and prevent further such rejects, daily
Effectively communicates via phone with customers, employees and vendors using exemplary customer service skills
Runs A/R report monthly to work on denials (works accounts receivable 90-120)
Assists patients with questions regarding insurance and/or account balances and assists front office with set up of patient payment plans
Properly completes timesheet, daily
Regular, consistent, and predictable attendance per PRO-PT’s attendance and punctuality policy;
Responsible for attention to detail, organization, cleanliness, strong multitasking and time management skills
All other duties as assigned IE: Training staff, ordering office supplies etc.
Knowledge, Skills, and Abilities
Knowledge of insurance guidelines and payer requirements
Knowledge and understanding of HIPPA
Knowledge of CPT and ICD-10 coding and medical terminology
Knowledge of medical professional fee billing
Knowledge of Managed Care, Work Comp, HMO, Medi-Cal, Medicare…etc.
(contracts)
Skill to perform computer & data entry functions
Able to operate office equipment, including but not limited to keyboard, copier, telephone, fax machine and calculator
Knowledge of proper lifting techniques
Detailed oriented and highly organized
Ability to type forty-five (45) wpm
Ability to self-motivate and work effectively in an independent environment
Ability to read and understand different EOB’s (explanation of benefits)
Ability to multi-task, recognize, evaluate, solve problems and correct errors
Ability to work well in a team environment.
Ability to successfully complete training.
Ability to communicate in writing, over the phone, and in person with office staff, patients and insurance representatives
Ability to explain instructions and guidelines to others effectively.
Ability to determine work priorities.
Education and Experience
High School Diploma or Equivalency.
Minimum of 1 year experience in healthcare billing
40-45 WPM
Data processing and medical terminology preferred.
Physical Requirements
Hearing: Adequate to perform job duties in person and over the telephone.
Speaking: Must be able to communicate clearly to patients and insurances over the telephone.
Vision: Visual acuity adequate to perform job duties, including visual examination of patient and reading information from printed sources and computer screens.
Other: Requires occasional lifting and carrying items weighing up to 35 pounds unassisted.
Requires bending, reaching, standing, walking, sitting (extended periods of time).
Working Conditions: Normal working conditions absent extreme factors.
Note: The above statements are intended to describe the general nature and level of work being performed.
They are not intended to be construed as an exhaustive listing of all responsibilities, duties, and skills required.
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