Clinic Biller

Prime Healthcare; Weslaco (TX); On-site; USD 40,000 - 60,000; Full time

Benefits offered by this job

Health, dental, and vision insurance

Job summary

Prime Healthcare in Weslaco, TX is seeking a Medical Biller to manage patient billing and insurance claims in the Physician Group or hospital setting. You will ensure accurate coding, timely reimbursements, and clear communication with patients and insurers.

This full-time daytime role focuses on coding accuracy, claim follow-up, and coordination with departments to secure payments. You will use medical terminology and work to support our community hospital teams.

Qualifications

• Previous hospital billing experience required.
• Experience with government programs and collections preferred.
• Knowledge of medical terminology.
• Effective written and verbal communication skills.
• Ability to multi-task and meet required timelines.
• Analytical and problem-solving skills.
• Customer service experience required.
• High School Diploma or GED required.

Responsibilities

• Submit claims to payers and ensure coding compliance with Medi-Cal/Medicare where applicable.
• Obtain required authorizations for processing and payment of claims.
• Follow-up and manage denials to achieve final resolution.
• Identify ICD9, CPT, HCPCS, DRG codes relevant to reimbursement.
• Communicate clearly with clients and staff by phone and in person.
• Maintain productivity standards and reports.
• Gather updated demographics and information to comply with billing requirements.
• Operate computer to input follow-up notes and retrieve patient information.

Skills

Verbal communication

Written communication

Analytical skills

Multi-tasking

Customer service

Education

High School Diploma or GED

Job description

Overview

Clinic Biller

Location: Knapp Medical Center - Weslaco, TX

Full-Time | Days | 8 - Hour Shifts | 8:00am - 5:00pm

As our Medical Biller, you will manage patient billing and insurance claims in ourPhysician Group or Hospital.The Medical Biller will ensureaccuratecoding,timelyreimbursements and clear communication between patients, insurers, and ourmedical group or hospitaldepartments.

Here are some of the benefits of working atPrime Healthcare:

• Health, dental, and vision insurance options

• Paid vacation, sicktimeand holidays

• Bereavement leave, FMLA and other leave options

• Employer 401K options

• Tuition reimbursement options

• Life, disability, and other insurance options

• Many other amazing benefits

At Knapp Medical Group, our dedicated team of professionals is committed to our core values of quality, compassion, and community. Affiliated with Knapp Medical Center, Knapp Medical Group is actively seeking new members to join its award-winning team!

Responsibilities

• The Biller is responsible for submitting claims to the appropriate intermediaries and to insure that procedures and charges are coded in compliance with all payers including Medi-Cal and/or Medicare regulations.
• Responsible for obtaining required authorizations necessary for the processing and payment of claims.
• The Biller is responsible for the follow-up and denial management as necessary for final resolution. Responsible to identify the various types of diagnosis and procedures codes (ICD9, CPT, HCPCS, DRG) as they relate to reimbursement. Communicates clearly and efficiently by phone and in person with clients and staff members.
• Maintains productivity standards and reports.
• Obtains updated demographic information and all necessary information needed to comply with the various Government Programs billing requirements.
• Operates computer to input follow up notes and retrieve collection and patient information. Maintains proficiency in Medical Terminology

Qualifications

Education and Work Experience

• Previous Billing Experience within a hospital Business Office Required.
• Previous experience with government programs and collections preferred.
• Knowledge of medical terminology
• Effective written and verbal communication skills
• Ability to multi-task, prioritize needs to meet required timelines
• Analytical and problem-solving skills
• Customer Services experience required
• High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires)

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Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf