Medical Biller/Coder

Prime Healthcare; Redding (CA); On-site; USD 32,000 - 36,000; Full time

Benefits offered by this job

Paid time off

401K retirement plan

Medical coverage

Dental coverage

Vision coverage

Tuition reimbursement

Job summary

Shasta Regional Medical Group, affiliated with Shasta Regional Medical Center, seeks an experienced Biller to handle claim submissions, coding compliance, and follow-up for denials. You will coordinate authorizations, maintain demographic data, and ensure government program requirements are met.

The role emphasizes clear communication with clients, adherence to productivity standards, and proficiency in EMR/PM billing software, with full-time daytime shifts in a clinically oriented setting.

Qualifications

• 1. Previous Billing Experience within a Clinic/Medical Group Business Office Required
• 2. Previous experience with government programs and collections preferred
• 3. Experience with Rural Healthcare billing preferred
• 4. Experience with EMR/Practice Management billing software required
• 5. Knowledge of medical terminology
• 6. Effective written and verbal communication skills
• 7. Ability to prioritize needs to meet required timelines
• 8. Analytical and problem-solving skills
• 9. Customer Services experience required
• 10. High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires)

Responsibilities

• Submit claims to intermediaries and ensure procedures and charges are coded in compliance with payers including Medi-Cal and Medicare.
• Obtain required authorizations necessary for processing and payment of claims.
• Follow-up and denial management for final resolution.
• Identify diagnosis and procedure codes (ICD10, CPT, HCPCS, DRG) as they relate to reimbursement.
• Communicate clearly by phone and in person with clients and staff.
• Maintain productivity standards and reports.
• Obtain updated demographic information and information needed to comply with government programs.

Skills

Billing experience

Government programs

Rural billing

Communication

Analytical/problem-solving

Customer service

Prioritization

Medical terminology

Written and verbal communication

Education

High School Graduate or GED

Tools

EMR/Practice Management software

Job description

Overview

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Shasta Regional Medical Group, affiliated with Shasta Regional Medical Center, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

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 (ICD10, 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, EXPERIENCE, TRAINING

• 1. Previous Billing Experience within a Clinic/Medical Group Business Office Required
• 2. Previous experience with government programs and collections preferred
• 3. Experience with Rural Healthcare billing preferred
• 4. Experience with EMR/Practice Management billing software required
• 5. Knowledge of medical terminology
• 6. Effective written and verbal communication skills
• 7. Ability to prioritize needs to meet required timelines
• 8. Analytical and problem-solving skills
• 9. Customer Services experience required
• 10. High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires)

Pay Transparency

Shasta Regional Medical Group offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $23.00 to $26.22. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

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

Privacy Notice

Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf