GENERAL DESCRIPTION

This position will primarily handle insurance claim submissions, payment posting, and researching claim rejects/denials. This position must have a thorough knowledge of government, commercial, HMO, PPO, and other types of insurance billing guidelines.

ESSENTIAL JOB FUNCTIONS

• Submits claims to government and commercial payers according to timely filing requirements.

• Posts payments and remittance advices in appropriate database(s).

• Tracks and collects aging accounts receivables.

• Research claim denials & clearinghouse edits.

• Completes requests for medical information and other related correspondence.

• Identifies and analyzes open claims and corrects billing errors.

• Re-submits claims to insurance carriers as appropriate.

• Monitors all past due accounts for payment.

• Contributes to a cohesive departmental unit.

• Maintains regular and predictable attendance.

REQUIRED SKILLS

• High School Diploma or GED

• Excellent written and oral communication skills

• Working knowledge of commercial and government insurance plans

• 1-2 years of previous medical billing experience

• Basic knowledge of Microsoft Office

• Medical terminology

• Self-starter, team player, analytic & problem-solving abilities

PREFERRED SKILLS

• Billing and/or coding education or certification

• Personal experience with a disability

COMPETENCIES

• Detail oriented.

• Maintains HIPAA and other confidentiality requirements.

• Remains flexible when faced with schedule changes, interruptions, or the need to deal with difficult situations.

• Demonstrates personal integrity and sound judgement.

• Works independently or as a team with little guidance.

• Models professional attitude and demeanor.

• Demonstrates sound time management and organization skills.

WORK ENVIRONMENT & PHYSICAL DEMANDS

This position operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. This is largely a sedentary role; however, some filing is required. This would require the ability to lift files, open filing cabinets and bend or stand as necessary.

OTHER DUTIES

Please note that this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

The Whole Person is an equal opportunity employer committed to hiring staff members reflecting the great diversity of our community. Reasonable accommodations will be made upon request. People with disabilities are strongly encouraged to apply.