JOB DESCRIPTION: BILLER
Responsibilities
- Performs all aspects of billing for commercial insurance companies/ health plans, medical groups, hospitals, hospice facilities, NCPDP, and/or MSO’s
- Bills Medicare for PR-96/204 (denials) required for secondary billing submissions.
- Follows up on EOB’s (explanation of benefits) which includes billing secondary insurance after Medicare’s has denied claims.
- Calling insurance companies for explanation of denials if questionable.
- Making corrections on deny claims and re-bills insurance companies.
- Checks EOB’s with contracted fee schedule for accuracy or adjustments as needed.
- Patient calls for benefit, invoicing, and explanations as needed.
- Resolving electronic (Office Ally, Novologix, or Emdeon clearing house) report matters.
Reporting Relationship
None
Scope of Supervision
None
Minimum Qualifications
- Effective interpersonal, time management and organizational skills.
- Office experience preferred.
- Computer skills that include word processing and efficient use of the internet and e-mail.
- Must possess excellent oral and written communication skills, with the ability to express technical issues in layman terms.
- Must be detail oriented.
Education and/or Experience
- Must have a High School diploma or Graduation Equivalent Diploma (GED) or Higher.
- At least 1–2 years of medical or pharmaceutical billing experience or related A/R.
- Knowledge of insurance verification procedures.
- Proficiency in 10-key preferred.
- Prior experience in a pharmacy or home health company is of benefit.
- Prior experience in a consumer related business is also of benefit.
Benefits for FULL TIME Employees
- 401K Matching Plan - Up to 4%
- Quarterly Bonus Opportunities
- Short Term / Long Term Disability Insurance
- Employee Assistance Programs
- Employee Discounts
- Fun Company Events
Equal Employment Opportunity (EEO)
It is the policy of Premier Infusion & Healthcare Services to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Premier Infusion & Healthcare Services will provide reasonable accommodations for qualified individuals with disabilities.