WHMG Billing - Physician Commercial Biller- FT - 1st Shift

Wilson Health; Buckeye Terrace (OH); On-site; USD 30,000 - 41,000; Full time

Benefits offered by this job

Free on-site clinic access

Generous PTO

HDHP/PPO options with insurance

Employer HSA contribution

Life Insurance

Long-Term Disability Insurance

Retirement plan with company match

Tuition Assistance

On-site gym access

Employee discounts

Job summary

Wilson Health in Sidney, OH is seeking a full-time Commercial Physician Billing Specialist. The role releases commercial payer claims electronically and mails 1500 claims as needed, with follow-up on unpaid claims and appeals as required.

The position reports to the Manager of Patient Accounts and requires prior physician billing experience and familiarity with payer requirements and EHR systems. Excellent attention to detail and communication are essential.

Qualifications

• High school diploma or GED required.
• Minimum of one year of prior physician billing experience.
• Experience with Epic or other EHR and patient accounting systems.
• Experience using Microsoft Excel.
• Familiarity with commercial payer requirements, professional billing, claim denials, and appeals.

Responsibilities

• Billing of claims through Electronic Vendor (Quadax) which requires keeping up to date with payer requirements and edits.
• Bills secondary, tertiary, etc., claims electronically or mails the 1500 with EOB as required by the payer.
• Monitors claims using various payer portals.
• Works closely with all physician groups and staff regarding charges and/or late charges.
• Appeals claims on behalf of the patient to secure payment, or if a claim has been denied for inappropriate reasons.
• Follows up on appeals; works mail as it applies to the Commercial Professional Billing Specialist to secure payment.
• Works closely with physician groups and staff, and Medical Records regarding denials for no authorizations and/or medical necessity to secure documentation and/or diagnosis to submit a corrected claim or appeal.
• Works underpayment records daily to ensure proper payment from payers and makes appropriate adjustments as required.
• Submits documentation to the Professional Supervisor or Manager of Patient Accounts for refunds.
• Receives calls from patients regarding balances, itemized bills, or EOBs.

Skills

Prior physician billing experience

Billing knowledge

Education

High school diploma or GED

Tools

Epic EHR

Microsoft Excel

Job description

Career Opportunities

Wilson Health is seeking a full-time, experienced Physician Commercial Biller for our location in Sidney, Ohio. Key Perks and Benefits:

• Access to Employer Direct Care Clinic. Free medical care and pharmacy services for eligible employees and dependents covered by Wilson Health's medical insurance plan.
• Generous paid time off (PTO) program beginning day one, designed to support work-life balance, rest, and time with family.
• Medical Insurance: Choose from two High-Deductible Health Plan (HDHP) options or a PPO plan, along with Dental and Vision coverage. Benefits begin on the first of the month following your hire date.
• HSA with employer contribution for eligible health plans; FSA for medical and dependent care expenses.
• Company-paid Life Insurance and Long-Term Disability Insurance
• Voluntary Accident, Critical Illness, and employee and dependent Life and AD&D Insurance.
• Industry-leading retirement plan – employer contributions begin day one with no waiting period for participation.
• Tuition Assistance Program
• Free access to an on-site gym, available 24/7, making it easy to prioritize your health and wellness before or after your shift.
• Employees receive a 10% discount on food and beverages at the Wilson Cafeteria, Coffee Bar and Micro Mart.

Employment Status: Full Time

Working Hours: Monday – Friday, Flexible Working Hours, Begin as Early as 6:30 am. Option for either 8 or 9 hour work day.

Position Reports To: Manager, Patient Accounting

Who We Are: At Wilson Health, our mission is to improve the health and wellness of our communities by delivering compassionate, quality care. We are committed to making a difference for our neighbors, friends, and family and our vision is to be a trusted, nationally recognized leader of innovative, collaborative community health.

POSITION SUMMARY: Under the direction of the Manager of Patient Accounts, the Commercial Physician Billing Specialist releases commercial payer claims electronically, and mails hard copy 1500 claims as required. The Billing Specialist will follow up on unpaid claims and rebill or Appeal claims as indicated.

KEY DUTIES AND RESPONSIBILITIES:

• Prior Physician Billing Experience required.
• Billing of claims through Electronic Vendor (Quadax), which requires keeping up to date with Payer requirements and/or edits.
• Bills secondary, tertiary, etc., claims electronically or mails the 1500 with EOB as required by the Payer.
• Monitors claims using various payer portals.
• Works closely with all physician groups and staff regarding charges and/or late charges.
• Appeals claims on behalf of the patient to secure payment, or if a claim has been denied for inappropriate reasons.
• Follows up on appeals. Works mail as it applies to the Commercial Professional Billing Specialist to secure payment.
• Works closely with physician groups and staff, and Medical Records regarding denials for no authorizations and/or medical necessity to secure appropriate documentation and/or diagnosis to submit a corrected claim or appeal.
• Works underpayment records daily to ensure proper payment from Payers and makes appropriate adjustments as required.
• Submits documentation to the Professional Supervisor or Manager of Patient Accounts for refunds.
• Receives phone calls from patients regarding account balances, itemized bills, or Explanation of Benefits.

Required Qualifications:

• High school diploma or GED.
• Minimum of one year of prior physician billing experience.

Preferred Qualifications:

• Experience with Epic or other electronic health record and patient accounting systems.
• Experience using Microsoft Office applications, particularly Excel.
• Familiarity with commercial payer requirements, professional billing, claim denials, and appeals.

Mission Vision Values:

Mission

To improve the health and wellness of our communities by delivering compassionate, quality care.

Vision

To be the most trusted choice for care in the communities serve.

Values

A.S.P.I.R.E. Always Serve with Professionalism, Integrity, Respect, and Excellence.

EOE (Equal Opportunity Employer)