Job Description

As a Surgical Medical Biller, you will be a vital part of the healthcare revenue cycle process, utilizing core skills in medical collection, EMR systems, and medical coding to ensure accurate and timely billing for medical services. Your premium skills in DRG, CPT coding, and ICD coding will be essential in navigating complex billing procedures and maximizing reimbursement. With a high school diploma or GED and knowledge of HIPAA regulations, you will play a critical role in managing billing processes for services provided at ambulatory surgery centers, ensuring compliance with Medicare guidelines. Join our team and contribute to the financial health of our healthcare organization.

About the Role

As a Surgical Medical Biller, you will be responsible for ensuring accurate and timely billing for medical services.

Responsibilities

• Know how to bill and recover payment for breast surgery and reconstruction surgery.
• Read the clinical documentation and pull clinical data and diagnoses from the chart.
• Resolve insurance claim rejections/denials, and non-payment of claims by payors.
• Identify trends in billing and follow-up, maintaining working knowledge of state and federal billing guidelines in order to identify ways in which our patients can expedite resolution of insurance accounts and identify delays in processing.
• Responsible for drafting effective appeals to insurance companies for reimbursement of monies owed.
• Responsible for maintaining daily account and follow-up work lists.
• Responsible for identifying, researching, and resolving: credit balances, missing payments and unposted cash as it pertains to billing account follow-up.
• Process, and maintain, within expectation, all correspondence received from patients and insurance companies as it pertains to correct and timely billing of claims, and receipt of payment.
• Communicate appropriately with insurance companies, patients, co-workers and supervisors.
• Follow up on claims in a timely manner.
• And other tasks as needed.

Qualifications

• High School Graduate or Equivalent.
• 2+ years experience in billing ASC/Surgery Center claims.
• Experience with major payers such as Anthem, Aetna, Medicare/Medicaid, United Healthcare.
• Must comply with HIPAA rules and regulations.
• Experience with the EMA system is a plus but not required.

Required Skills

Core skills in medical collection, EMR systems, and medical coding.

Preferred Skills

Experience with DRG, CPT coding, and ICD coding.

Pay range and compensation package

Job Type: Full-time

Schedule: 8 hour shift, Monday to Friday

Equal Opportunity Statement

We are committed to diversity and inclusivity in our hiring practices.

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