Bill facility (HB) and professional (PB) claims to insurance payers or other entities per SBO standard work.
Submit basic itemized statements, medical records, and other required information to insurance payors via clearinghouse, mail, or other electronic means.
Verify and update insurance coverage as applicable using EHR tools, payer websites, or via phone calls to payers.
Resolve complex billing related claim edits within EHR, DNBs and Stop Bills.
Resolve complex payer rejections including Medicare return to provider (RTP) and clearinghouse rejections (277’s).
Split and combine claims as required by payer.
Obtain ICN’s for pending corrected claims using EHR tools, payer websites, or via phone call to payers.
Apply intermediate knowledge of current reimbursement methodologies as defined by department complexity matrix.
Apply intermediate knowledge of billing requirements as defined by department complexity matrix.
Process late charges using the late charge functionality.
Generate and release medical records.
Split charges to a separate HAR or liability bucket and combine charges to a single HAR as needed.
Submit corrected claims.
Update claim information including ICN, authorizations, billing information, or other required claim elements.

High school graduate or GED
Course work in medical terminology or other revenue cycle functions such as RHIT or medical coding (preferred)
Three years of healthcare experience, of which two years must have been in billing or equivalent role
One year of Epic experience
Knowledge of standard billing requirements
Intermediate knowledge of payer reimbursement methodologies
Basic skills in Microsoft Office applications including Excel, One Note, Outlook, and Word

Competitive Salary
Comprehensive benefits including Medical, Dental, Vision for you and your immediate family
403b with up to 6% match on Retirement Contributions
Generous Earned Time Off
Growth Opportunities within Healthcare

Insurance Biller

About this role