Biller

Raphael Health Center Inc; Indianapolis (IN); On-site; USD 42,000 - 56,000; Full time

Job summary

Raphael Health Center Inc. is seeking a Billing Specialist to manage denial follow-up, review EOBs, and ensure accurate coding for denied claims. The role includes rebilling corrections, coordinating with payors, and supporting front office and patient accounting functions.

The ideal candidate will have billing experience, familiarity with Medicaid/Medicare, and proficiency in MS Office and Practice Management Systems, ECW preferred. Bilingual Spanish is a plus.

Qualifications

• Business school training in medical billing or 2+ years’ experience as a billing specialist.
• Knowledge of medical terminology, claims processing, and medical coding.
• Understanding of managed care concepts including HMO, MCE and capitation.
• Solid understanding of Medicaid and Medicare.
• Solid understanding of the complete billing cycle.
• Proficiency with MS Office and Practice Management Systems (ECW preferred).
• Strong interpersonal and communication skills with diverse stakeholders.
• Bilingual in Spanish a plus.

Responsibilities

• Handle claims denial follow-up.
• Review Explanation of Benefit correspondence to identify billing errors.
• Review patient charts to identify proper coding for denied claims.
• Re-bill corrected claims with high proficiency.
• Follow-up with third-party payors to ensure compliance with guidelines.
• Provide Front Office support.
• Ensure patient accounting system closes timely.
• Perform electronic and paper claim submission.
• Submit invoices to health care systems.
• Submit billing corrections as necessary.
• Post payments from deposit sheets and EOPs.
• Post all cash receipts to patient accounts.
• Assist clinic staff with patient accounting procedures.
• Collaborate with supervisor to increase revenue and efficiency.
• Communicate outstanding billing required from providers promptly.
• Maintain confidentiality per policy and HIPAA.

Skills

Medical terminology

Claims processing

Medical coding

MS Office

Practice Management Systems

Interpersonal communication

Bilingual Spanish (plus)

Education

Business school training in medical billing

Tools

ECW

Job description

Description

Scope of Tasks & Responsibilities:

• Handle claims denial follow-up.
• Perform thorough review of Explanation of Benefit correspondence with identification of billing error(s)
• Review of patient medical charts to identify proper coding for denied claims.
• Re-bill corrected claims with high degree of proficiency
• Follow-up with third-party payors to ensure compliance with established guidelines for billing and claim reimbursement
• Provide Front Office support
• Ensure patient accounting system is accurately closed on a timely basis.
• Perform electronic claim filing and paper claim submission
• Submit invoices to health care systems
• Submit billing corrections as necessary. Corrects charge, adjustment and receipt entry errors
• Post payments from deposit batch sheets and EOPs.
• Post all cash receipts to patient accounts
• Assist Clinic staff with patient accounting and related procedures
• Collaborate with their supervisor to increase revenue and system efficiency
• Communicate all outstanding billing required from Providers on a timely basis.
• Maintain confidentiality in accordance with RHC policy, HIPAA and any other applicable regulatory requirements.
• Exemplify the RHC mission through a personal example of excellent service to patients, visitors and coworkers.
• Attend regularly scheduled staff meetings
• Provide coverage for absent team members.
• Other duties as assigned

Requirements

Required Education, Certification, Experience and Skill:

• Business school training in medical billing preferred or comparable two years’ experience (minimum) as a billing specialist.
• Have demonstrated knowledge/experience with medical terminology, claims processing, and medical coding.
• Have a thorough understanding of managed care concepts including HMO, MCE and capitation
• Have a solid understanding of Medicaid and Medicare.
• Have a solid understanding of the complete billing cycle.
• Dental billing experience a plus.
• Proficient with MS Office and Practice Management Systems [ECW preferred].
• Strong interpersonal and communication skills with an ability to work effectively with a wide range of people, supervisors, co-workers and vendors.
• Exceptional customer service skills
• Bilingual in Spanish a plus.