Insurance Biller - Government Programs FT Days

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

Job summary

Torrance Memorial Medical Center in Torrance, CA is seeking an Insurance Biller to manage paper and electronic billing and collections under direct supervision. You will review codes, verify eligibility and authorizations, and work aging across PPOs, Medicare, HMO, cash and workers' comp.

The role requires 1 year of billing or collection experience in a medical office or hospital, with attention to documentation and payer communications.

Qualifications

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

Responsibilities

• Review claim edits and scrubber performance.
• Maintain payor-related items such as EFTs and Payor IDs for 835s.
• Verify insurance eligibility and authorizations.
• Handle monthly aging for PPOs, Medicare, HMOs, cash and workers' compensation.
• Document detailed notes including action items.
• Respond to payers, patients and other departments.
• Review reports to identify denials and resubmit claims with accurate ICD-9,ICD-10 and CPT codes; suggest prevention actions.
• Escalate issues to Supervisor.
• Assist with orientation and training of new employees/volunteers.

Skills

Billing and collections

Insurance verification

Claim denial management

Documentation

Tools

ICD-10 coding

CPT coding

Payor ID management

Job 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..

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

1

Type of Experience

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

Compensation Range

$25.00 - $33.44 / Hour