Overall Responsibility

The Accounts Receivable Biller is responsible for timely billing, internal review process, and insurance functions in the hospital.

Key Tasks and Responsibilities

Essential Functions:

• Files appeals timely on underpaid or denied accounts with a good understanding of medical necessity guidelines specific to procedures.
• Effectively makes payment arrangements with patients for timely resolution of balances, following self-pay policy.
• Posts write-offs, account adjustments, and corrections daily to patient accounts. Enters and reconciles all charges and credits to patient accounts.
• Files electronic and/or paper insurance claims daily.
• Reviews each Explanation of Benefits received with payments to verify determination of payment to the facility has been reimbursed correctly and begins the appeal process as necessary.
• Reviews the status of assigned accounts for unpaid claims and follows up appropriately with insurance companies or patients.
• Uses or has knowledge of how to appropriately use the Medicare FISS system, Medicaid system, and Rycan/Truebridge system for billing and claims inquiry.
• Uses time effectively and productively, eliminating distractions.
• Works insurance aging effectively and timely to meet department goals.
• Assists the Patient Service Manager with reports or other projects as requested.
• Handles phone calls from assigned accounts regarding account balances or insurance filings.
• Documents concisely, precisely, and accurately on records or documents as indicated by policy.
• Communicates effectively and works cooperatively and professionally with all co-workers, management, patients, visitors, physicians, and others. Demonstrates work as a team player.
• Participates in Quality Assessment activities as directed for the continuous improvement of patient care and hospital business.

Non-Essential Functions:

• Performs other duties as assigned.
• Actively supports and upholds the mission and core values of the hospital.
• Remains knowledgeable of and follows the policies of the hospital.
• Always maintains patient and hospital confidentiality.
• Keeps the Manager apprised of day-to-day situations.

Experience Required

• High school diploma or equivalent required.
• Two years of previous experience with accounts receivable, billing, and insurance required.
• Computer skills, basic office skills, and knowledge of medical terminology required.

Environmental and Physical Requirements

• Must be able to read and speak English fluently.
• Requires cognitive skills for math, reading, computer skills, and communication skills to interact effectively with the public and peers.
• Vision requirements: near, mid-range, far, and accommodation.
• Hearing requirements: low, medium, and high-pitched sounds.
• Minimal up-and-down activity may be required.
• Job risks include exposure to computers for 6-7 hours per day with typing activities.
• Must be able to lift a maximum of 20-30 pounds.

 Equal Employment Opportunity (EEO) & Americans with Disabilities Act (ADA) Statement:

• Our hospital is committed to fostering an inclusive and diverse workplace. We provide equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other characteristic protected by applicable law. Additionally, we provide reasonable accommodation for qualified individuals with disabilities in the application and employment process. If you require assistance or accommodation due to a disability, please contact Human Resources so that we may engage in an interactive process to determine appropriate accommodation.