Insurance Biller I

Community health is about more than just vaccines and checkups. It's about giving people the resources they need to live their best lives. At Neighborhood, this is our vision. A community where everyone is healthy and happy. We're with you every step of the way, with the care you need for each of life's chapters. At Neighborhood, we are Better Together.

As a private, non-profit 501(C) (3) community health organization, we serve over 414,995 medical, dental, and behavioral health visits from more than 87,099 people annually. We do this in pursuit of our mission to improve the health and happiness of the communities we serve by providing quality care to all, regardless of situation or circumstance.

We have been doing this since 1969 and it is our employees that make this mission a reality. Regardless of the role, our team focuses on being compassionate, having integrity, being professional, always collaborating, and consistently going above and beyond. If that sounds like an organization you want to be a part of, we would love to have you.

The Insurance Biller I works to support the mission and vision of Neighborhood Healthcare (NHC) by processing and supporting the medical billing process for patients and other funding sources. This role will validate correct coding processes to ensure compliance with NHC, contracts, funding programs, and agencies.

Responsibilities

Reviews progress notes to obtain payer measures and requirements information for proper submission compliance
Reviews and obtains required information for missing and incomplete billings, such as missing DX, procedure codes, payer specific needs, eligibility screening, and coverage verification
Creates and submits claims for clean billable charges and statements in compliance of correct coding initiatives and billing industry requirements
Processes and monitors system claim status categories to ensure all transactions are captured for month end close
Registers patients in the payment portal, as needed
Reviews, processes, and obtains patient eligibility information to ensure accuracy and completion, including acquisition of authorization numbers, as needed
Applies discounts to billing statements for patients eligible for the Sliding Fee Discount Program (SFDP), as needed
Posts patient and insurance payments to account balance adjustments and write offs, as assigned
Reviews and processes refunds and insurance recoupment requests
Submits patient statements on cash accounts, as needed
Processes monthly collection accounts for collection agencies, as needed
Supports the patient billing phone lines and voicemails; return calls, as needed
Discusses billing inquiries with patients to resolve account questions and/or problems
Negotiates payment plans with patients, as needed
Provides excellent customer service to patients and escalate issues to a supervisor, if needed
Responds to site, insurance, and patient correspondences related to billing in a timely manner
Attends billing training and team meetings

Qualifications

Education/Experience:

High school diploma/GED required
Medical Billing or Coding Certification from an accredited school preferred
One year of medical billing experience in a healthcare environment required
Experience working in a specialty and/or FQHC community clinic is preferred

Additional Qualifications (Knowledge, Skills and Abilities)

Excellent verbal and written communication skills, including superior composition, typing and proofreading skills
Ability to interpret a variety of instructions in written, oral, diagram, or schedule form
Knowledgeable about and experience with insurance eligibility processes and coverage guidelines for multiple carriers
Knowledgeable about and experience with billing compliance standards
Knowledgeable on uses of CPT, HCPCS, and ICD codes
Knowledgeable with insurance payers, funding sources, and managed care plans.
Ability to successfully manage multiple tasks simultaneously
Excellent planning and organizational ability
Ability to work as part of a team as well as independently
Ability to work with highly confidential information in a professional and ethical manner

Pay Range: $22.25 - $29.75 per hour, depending on experience.