Professional Biller- Cedar Eye Center

marshallmedical; Placerville (CA); On-site; USD 31,000 - 38,000; Full time

Job summary

Marshall Medical in Placerville, CA is seeking a Professional Biller to manage all aspects of patient billing, including claim submission, follow-up, payments, and revenue cycle management. You will act as the liaison between providers, patients, and payers to ensure accurate, timely billing.

Key duties include reviewing bills for accuracy, resolving discrepancies, handling inquiries, performing collections in accordance with privacy and billing regulations, and staying current with changing

Qualifications

• High school diploma or GED required.
• Minimum 3 years' billing experience required.
• Comprehensive knowledge of CPT, HCPCS, ICD-10, insurance billing and appeals.
• Proficient with Office, EHR, and Epic billing software.
• Knowledge of Medicare, Medi-Cal, and other payer types preferred.
• Understanding of HIPAA and state privacy rules in billing.

Responsibilities

• Manage all aspects of patient billing including claims processing and revenue cycle activities.
• Review bills for accuracy and submit/follow up on insurance claims.
• Communicate with payers and patients to resolve discrepancies and inquiries.
• Perform collection activities while ensuring compliance with privacy regulations.
• Stay informed on changing billing regulations and payer guidelines.
• Assist in interpreting contract and rate sheets for insurance purposes.

Skills

Customer service

Organization

Decision making

Teamwork

Multi-tasking

Data entry

Contract interpretation

Education

High school diploma or GED

3 years billing experience

Tools

Epic billing software

EHR

Microsoft Office

Job description

Department: MMF Vision Center Shift: Primarily Days (United States of America) Employee Type: Regular Per Diem Type (if applicable): Minimum Pay Range: $22.69 - $27.23

Job Description

POSITION SUMMARY

The Professional Biller is vital to healthcare operations, responsible for managing all aspects of patient billing, including claim processing, payments, and revenue cycle management. They serve as a liaison between healthcare providers, patients, and insurance companies to ensure accurate, efficient billing processes. Key duties include reviewing bills for accuracy, submitting and following up on insurance claims, resolving discrepancies, and communicating with payers. They also are a resource regarding patient inquiries, perform collection activities, and ensure compliance with privacy and billing regulations. Staying informed of changing billing procedures and regulations is essential to maintain efficient and compliant billing operations.

POSITION QUALIFICATIONS

• Education/Licensure/Certification: High school diploma or GED required.
• Knowledge/Experience: Minimum 3 years' billing experience required.
• Comprehensive working knowledge of medical terminology, CPT, HCPCS, ICD-10, insurance billing and appeals processes.
• Knowledge and use of Office, PC, Microsoft Office, EHR, Epic billing software, and basic office equipment.
• Current working knowledge of various Payers; Medicare, Medi-Cal, RHC, Commercial, workers compensation and other claims preferred.
• Understanding of governmental agencies, commercial insurances, state & county compliance guidelines with regards to billing preferred.
• Must have basic knowledge of Knox-Keene, ERISA and California State laws that impact the billing process.
• Must have basic knowledge of HIPAA and California State Confidentiality laws that impact the release of medical information.

Skills

• Superior customer service skills including oral, written, and listening skills in dealing with patients, physicians' office staff, co-workers, and payers.
• Has good organizational skills and flexibility.
• Ability to make reasonable independent decisions in the absence of immediate direct supervision that stay within hospital and department guidelines.
• Works as a team player assisting co-workers during periods of peak workloads and short staffing.
• Must possess the ability to multi-task and reprioritize workload in order to meet deadlines.
• 30 CWPM Data entry, ten-key skills required, basic filling skills, alphabetic, numeric and basic math skills required.
• Ability to interpret contract and rate sheets for insurance.