Monument Health is a healthcare provider that focuses on patient financial services, and they are seeking a Biller I to ensure the proper interpretation, processing, recording, approval, and payment of medical claims. The role involves reviewing claims, maintaining documentation, and providing customer service while adhering to compliance standards.
Responsibilities
- Demonstrates application of compliance standards and payer specific data to properly file claims and ensures prompt, appropriate reimbursement of services and supplies billed to third parties and appropriate payment of services and supplies due from patients, as evidenced by documentation, observation and feedback
- Demonstrates a working knowledge of third party payer procedures including, but not limited to: Commercial Payers, Veterans Administration, worker' compensation, third-party liability, county payers, and all other third party contractual agreements as required
- Conducts timely follow up of claims. Use tools provided to track and trend patterns of claim submission issues that might require Compliance and Charge master staff to resolve, or HIPAA transaction code set review. Research payer requirements and offer suggestions to leadership for claims submission issues
- Maintains and updates appropriate system documentation to provide information regarding claim processing to internal or external customers
- Identifies unresolved requests of patient responsibility and transfers account to self pay. Performs duties and provides best customer service using behaviors that demonstrate responsibility and accountability
- Participates in departmental activities related to performance improvement and quality control
- Demonstrates a working knowledge of denial follow up and first level appeals
- All other duties as assigned
Skills
- Education - High School Diploma/GED Equivalent in General Studies
- Experience - 1+ years of Clerical Experience
- Experience - 1+ years of Medical Patient Accounts/Financial Services Experience
- Education - Bachelors degree in Accounting, Business, Health Related Field
- Certifications - Certified Clinical Account Technician (CCAT) - Accredited University or accredited training professionals
- Certifications - Certified Patient Account Technician (CPAT) - Accredited University or accredited training professionals
Benefits
- Supportive work culture
- Medical, Vision and Dental Coverage
- Retirement Plans, Health Savings Account, and Flexible Spending Account
- Instant pay is available for qualifying positions
- Paid Time Off Accrual Bank
- Opportunities for growth and advancement
- Tuition assistance/reimbursement
- Excellent pay differentials on qualifying positions
- Flexible scheduling
Company Overview
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