Medical Biller - Team G.A.I.N. California, Inc.

Medical Billing

First Shift availability

$21-$30/hr DOE

Benefits

Job description

The Medical Billing Specialist is responsible for planning, organizing, and coordinating daily operations to ensure quality patient financial services and streamlined access to service for all patients. Responsibilities include providing administrative and clerical services, coding, billing, collection of payments, and input process improvement.

Qualifications and Requirements
• Document all prior authorization information, including approval dates, billing units, procedure codes, and prior authorization number in the patient profile.
• Review the accuracy and completeness of the information requested and ensure that all supporting documents are present.
• Receive requests for prior authorization and ensure that they are properly and closely monitored within company-set standards.
• Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed.
• Collaborate with other departments to assist in obtaining prior authorization /appeals.
• Proactively work on prior authorizations that are due to be expired.
• Insurance verification for new and current patients, review of incoming authorizations, and accurate input into electronic medical records system (“EMR”).
• Responsible for determining patient financial responsibility as determined by the insurance company.
• Research and verify patient demographic information through online verification systems.
• Verify insurance eligibility; get authorization and ability to identify different kinds of insurance coverage and limitation.
• Excellent verbal and written communication skills to communicate with diverse populations including physicians, employees, patients, and families.
• Analytical skills to evaluate patients’ financial responsibility across all departments based on the guidelines provided.
• Work effectively and professionally with others while maintaining office etiquette and employee morale.

• Collaborate with other staff in the department and other departments to ensure continuity and quality of care.
• Ability to efficiently multi-task, work independently and problem solve.
• Demonstrate a high level of professionalism and accountability.
• A high school diploma required
• Billing Certification required
• Excellent computer skills and EMR knowledge

Experience
• Minimum of 1 year experience in the health care industry required including Medicare/Medical and HMO electronic claims submission.
• Must be familiar with the medical authorization process for all types medical insurance including accessing portals of various health plans.
• Exposure in an Oncology and/or Imaging setting is highly preferred but not required.