Insurance Biller - Government Programs FT Days

Torrance Memorial; Torrance (CA); On-site; USD 34,000 - 46,000; Full time

Job summary

Torrance Memorial in Torrance, CA seeks an Insurance Biller under direct supervision responsible for all aspects of paper and electronic billing and collections, including auditing codes and verifying insurance.

The role requires meticulous attention to claim edits, eligibility checks, and timely responses to payers and patients. Experience in PPOs, Medicare, and workers' comp billing is preferred; compensation ranges from $25.00 to $33.44 per hour.

Qualifications

• One year billing or collection experience in a medical office or hospital.

Responsibilities

• Review claim edits and scrubber results.
• Maintain payor-related items including EFTs and Payor IDs for 835s.
• Verify insurance eligibility and authorization.
• Work monthly aging for PPOs, Medicare, HMO, cash, and Workers' Compensation.
• Document detailed notes including action items taken.
• Respond timely to inquiries from payers, patients and other departments.
• Review denials from Medicare, PPOs, Workers' Compensation, Commercial and contracted carriers; correct and resubmit claims with accurate ICD-9/ICD-10 and CPT codes; suggest action plans to reduce future denials.
• Elevate issues to Supervisor.
• Assist with orientation and training of new employees/ volunteers.

Skills

Claim edits review

Payor IDs

Insurance eligibility

Aging analysis

Documentation notes

Payer inquiries

Denial analysis

Escalation

Job description

Description

Under direct supervision, the Insurance Biller is responsible for all aspects of paper and electronic billing as well as collections activities including reviewing and auditing codes and verifying insurance..

Under direct supervision, the Insurance Biller is responsible for all aspects of paper and electronic billing as well as collections activities including reviewing and auditing codes and verifying insurance..

Core Competencies

• Reviews claim scrubber and resolves claim edits.


• Maintains payor-related items, such as EFTs and Payor IDs for 835s.


• Verifies insurance eligibility and authorization.


• Works monthly aging of PPO's, Medicare, HMO's, cash and Workers Compensation.


• Documents detailed notes including action items taken, when appropriate.


• Responds timely and accurately to all incoming correspondence and inquiries from payers, patients and other departments.


• Reviews reports to identify denials from Medicare, PPOs, Worker Compensation, Commercial and Contracted carriers; corrects and resubmits claims using accurate ICD-9,ICD-10 and CPT codes; suggests action plans to eliminate denials in the future.


• Elevates issues as appropriate to Supervisor.


• Assists with orientation and training of new employees/ volunteers, as assigned.

Experience

Number of Years Experience

Type of Experience

1One year billing or collection experience in a medical office or hospital.

Compensation Range

$25.00 - $33.44 / Hour