Medical Biller

Choptank Community Health’s vision is to improve the health and well-being of the communities we serve; to provide an outstanding care experience; and to be an exceptional place to work and make a difference.

Job Summary: The Medical Biller is primarily responsible for utilizing the Athena EMR platform to ensure claims are processed and paid timely. This position will support one of the six health centers within Choptank Community Health System (CCHS) and the School Based Health Centers (SBHC). The responsibilities include reviewing claims, posting some payments, follow-up of accounts, answering of patient calls and staff from the outlining centers and management. This position will involve additional responsibilities as performance demonstrates capacity.

Required Skills/Abilities:

• Must be able to work independently and have excellent problem-solving skills to be able to judge urgency of need for accurate results.
• Familiar with data entry and Practice Management Systems.
• Must have working knowledge of medical terminology and word usage to ensure accurate appointment scheduling and concise, detailed oriented performance to ensure optimum referral tracking and follow-up.
• Highly organized and self-motivated
• Ability to work with others in a team base setting.
• Must possess valid drivers’ license and have dependable transportation.

Education and Experience:

• High School Graduate or equivalent.
• Knowledge of business and accounting processes usually obtained from an associate degree, with a degree in Business Administration, Accounting, or Health Care Administration preferred.
• Minimum of one to three years of experience in billing for a medical office, preferably in an FQHC environment.
• Computer skills in Microsoft Word, Excel, Outlook, and a Practice Management System.
• Knowledge of CPT & ICD-10 coding preferred. Experience in medical terminology helpful.

Core Values:

• Commitment To Service
• Respect
• Quality
• Teamwork
• Patient Focus
• Integrity
• Accountability
• Caring & Compassion
• Professionalism
• Listening & Responding
• Safety
• AIDET

Job Related Competencies:

• Attention to Detail- The ability to process detailed information effectively and consistently.
• Problem Solving- Identifies and analyzes problems weighing the relevance and accuracy of available information. Generates and evaluates alternative solutions and makes effective and timely decisions.
• Communicates Effectively- Developing and delivering multi-mode communication that convey a clear understanding of the unique needs of different audiences.
• Values And Ethics- Serving with integrity and respect in personal and organizational practices. Ensuring decisions and transactions are transparent and fair.
• Time Management- The ability to effectively manage one’s time and resources to ensure that work is completed efficiently.

Duties/Responsibilities:

• Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
• Following up on unpaid claims within standard billing cycle timeframe.
• Checking each insurance payment for accuracy and compliance with contract discount.
• Calling insurance companies regarding any discrepancy in payments if necessary
• Obtaining pre-authorizations as required.
• Identifying and billing secondary or tertiary insurances.
• Reviewing accounts for insurance of patient follow-up.
• Researching and appealing denied claims.
• Checking eligibility and benefits verification for treatments and procedures.
• Reviewing patient bills for accuracy, completeness and obtain any missing information.
• Answering all patient or insurance telephone inquiries pertaining to assigned accounts.
• Setting up patient payment plans and work collection accounts.
• Updating cash spreadsheets and running collection reports.
• Meets deadlines as assigned.
• Regular, reliable attendance is a requirement of this job.

Job Type: Full-time

Pay: $19.00 - $21.00 per hour