Description
Medical Biller
As a Medical Biller, you’ll be a vital part of a billing and claims workflow that should be seamless to our patients, but effective in ensuring claims and billing are completed with accuracy and efficiency to optimize Vera’s revenue generation. Vera’s vision for the position is that we have someone who understands medical billing, coding and isn’t afraid to dig in, driven to find answers to resolve billing/claims, and up to the challenge of working at a young, dynamic company seeking process improvement at every level.
Position Qualifications/Essential Functions:
● Work as a Billing Subject Matter Expert to support Revenue Cycle Activities, Partners and other departments. Ensuring alignment to the Vera Whole Health model is demonstrated across the board
● Assist with Policy and Procedure design and implementation
● Review negative AR trends or inefficient processes and work with leadership, training and partner teams to assess and address root cause
● Assist with EFT enrollment
● Support insurance and patient calls regarding payment, billing questions and account corrections
● Ensures clean claims are sent to insurance carriers in a timely manner, processing claims from the Practice Management system. This process includes working edits generated by the claim scrubbing software in NextGen, and ensuring claims are processed accurately in Clearinghouse
● Monitors claims for missing or incorrect information
● Ensures responses from insurance carriers for services provided are resolved in a timely manner to optimize Vera Whole Health’s revenue generation and cash flow, including posting of denials, working rejected claims and posting zero pay remits
● Secure needed medical documentation required or requested by insurance
● Completes the processing of inappropriately paid accounts by contacting payers, processing payer correspondence, rebilling, working denials and conducting appeals to obtain the highest possible reimbursement
● Process and post insurance and patient payments, ensuring accuracy for account reconciliation, including resolution of payment conflicts
● Work credit balance reports to identify insurance and patient overpayments, resulting in refunds
● Aged A/R account reconciliation includes investigation into account balances that have not been processed or paid by insurance companies
● Works directly with Regional Area Manager, Clinic Managers and Finance to ensure patient concerns regarding billing are resolved to patient satisfaction
● Special Projects as assigned
Education/Experience:
● High school diploma or GED
● Minimum 3-5 years of experience in medical billing with a strong familiarity and proficiency with Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-10) Tenth Edition codes.
● Experience with Athena and/or Next Gen billing EMR systems preferred
● Knowledge of Commercial, Medicare, Medicare Advantage and Workers Comp insurance plans
● 3+ years’ experience with billing/collection practices and workflows
● Experience with EMR chart and code review required
● Demonstrated knowledge of medical terminology
● 3-5 years’ experience with MS Office 2010 or higher and Google products
Additional Qualifications Preferred:
● Biller/Coder certification preferred
Demonstrated Attributes:
● Demonstrate an understanding of and commitment to The Vera Way by practicing its key components of mindfulness, continuous learning, a coach approach, innovation, adaptability and resilience with all members of Vera's staff, clients and patients.
● Highly organized
● Team player with strong interpersonal skills and ability to build effective working relationships throughout all levels of the organization - Excellent verbal and written communication
● Solution-focused
● Ability to be creative and innovative in a fast paced environment with a lot of ambiguity and constant change
● Ability to champion quality throughout the organization
Compensation: $21.50/hr. - $27/hr. (national average, premium markets may vary)
