The Biller is responsible for accurate and timely preparation and submission of claims to Government, Commercial, Secondary and Managed Care payers, as assigned. Monitors and/or corrects submitted claims to ensure accurate and prompt reimbursement of claims. Resolves issues and inquiries.
Responsibilities
- Reviews diagnosis, procedure codes, and charges for accuracy and obtains missing information from appropriate department when necessary. Updates insurance information and financial class in appropriate financial systems.
- Accurately identifies, prepares and keys electronic billing. Ensures accurate input of all UB04 information in the electronic system. Enters and transmits claims on a daily basis and in a timely manner. Ensures that error/reject reports are addressed in a timely manner. Updates account with correct activity code and/or comments in corresponding financial systems. Maintains zero billing WIP. Completes all required follow-up to prevent delays in payment. Maintains electronic tracking logs as assigned.
- Takes conscious ownership for work and takes a proactive, deliberate, and thoughtful approach regarding work activities. Demonstrates appropriate use of independent judgement and decision making. Demonstrates excellent customer service at all times. Maintains confidentiality in accordance with hospital/corporate policies and HIPAA privacy regulations.
- Recognizes potential issues/delays with payor so that corrective actions can be taken. Obtains information, as needed, from appropriate internal sources. Responds in a timely manner to avoid AR aging. Submits accurate and timely written online adjustments, as needed. Escalates payment delays/problem accounts to director in a timely manner.
Qualifications
Required Qualifications:
- High School Diploma or Equivalent
- One year recent experience in hospital billing
- Computer literacy and proficiency
- Ability to multitask and prioritize needs to meet timelines
- Understanding of basic medical terminology
- Must be able to read, write and communicate effectively in English
- Must demonstrate customer service skills appropriate to the job
Preferred Qualifications:
- Two years recent hospital billing experience
Pay Rate: Min - $22.20 | Max - $30.50
About Us
Prospect Medical Holdings' ability to deliver quality, compassionate care during the unprecedented pandemic affirms the original vision of its founders. This is the fulfillment of the hopes Prospect’s founders had for the company, and proof that a clear vision, an insightful operating model, and a commitment to communities and our employees, born in the past, remains the way of the future.
Every day, our more than 11,000 affiliated physicians and 18,000 employees at 17 hospitals, 165 outpatient centers and 28 medical groups provide nationally recognized care in six states. Our comprehensive network of quality healthcare services is designed to offer our patients and 600,000 members highly coordinated, personalized care tailored to the unique needs of each community we serve—many of which provide essential medical services to underserved communities as safety-net hospitals.