Professional Insurance Biller

Marshall Medical Center; Placerville (CA); On-site; USD 31,000 - 38,000; Full time

Job summary

Marshall Medical Center seeks a Professional Biller to manage patient billing and revenue cycle operations. The role involves reviewing bills, submitting insurance claims, and resolving discrepancies to ensure accurate, timely billing.

The ideal candidate has at least 3 years in medical billing, knowledge of CPT/HCPCS/ICD-10, and experience with Epic billing software. Strong communication and regulatory compliance skills are essential.

Qualifications

• High school diploma or GED required.
• Minimum 3 years’ billing experience required.
• Knowledge of 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 knowledge of Medicare, Medi-Cal, RHC, Commercial, workers compensation and other claims.
• Understanding of governmental agencies, commercial insurances, state & county compliance guidelines.

Responsibilities

• Manage all aspects of patient billing and revenue cycle.
• Submit and follow up on insurance claims; resolve discrepancies.
• Serve as liaison between providers, patients, and payers.
• Respond to patient inquiries and perform collection activities.
• Ensure compliance with HIPAA and billing regulations; stay updated on changes.

Skills

Customer service

Organizational skills

Independent decisions

Team player

Multi-tasking

CWPM Data entry

Ten-key data entry

Filing skills

Contract/rate sheet interpretation

Education

High school diploma or GED

Tools

Office software

Microsoft Office

EHR

Epic billing software

Job description

Department:

MMF Physician Clinic Billing

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:

• Highschool diploma or GEDrequired.

Knowledge/Experience:

• Minimum 3 years’billingexperiencerequired.

• Comprehensive working knowledge of medical terminology, CPT, HCPCS, ICD-10, insurancebillingandappealsprocesses.

• 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 ofgovernmental agencies, commercial insurances, state & county compliance guidelines with regards to billing preferred.

• Must have basic knowledge of Knox-Keene,ERISAand California State laws thatimpactthebilling process.

• Must have basic knowledge of HIPAA and California State Confidentiality laws thatimpacttherelease 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 playerassistingco-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 skillsrequired, basic filling skills, alphabetic,numericand basic

mathskillsrequired.

• Ability to interpretcontractand rate sheets for insurance.