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Westchester Medical Center SR MEDICAL BILLER in PORT JERVIS, New York

JOB SUMMARY: *Senior Biller / Senior Medical Biller manages the revenue cycle workflow for assigned practices, including posting electronic and paper remittances, review and correct clearinghouse errors, respond to phone calls from patients regarding balances, post charges as needed, review unpaid claims and resolve issues with insurance companies, review overdue accounts and send to collection as needed, create and prepare documentation for refunds to insurance companies and patients. *

RESPONSIBILITIES:

  • Posts payments, both electronically and manually, in a timely and accurate manner.
  • Recognizes and corrects errors that may occur during the downloading of the payments. Consistently reaching goal of having 100% of remittances posted by the last day of each month.
  • Posts manual charges as needed, in an accurate and timely manner.
  • Communicates with the provider if changes are needed in coding, reviewing the charges for appropriate modifiers and diagnoses, and correcting and resubmitting the charges as well as correcting clearinghouse issues. Consistently reaching goal of having 100% of claims posted and released by the 7th day of the month, for the previous month.
  • Follows up on partially paid or unpaid claims on a regular basis to accomplish the goal of having no more than 15% of unpaid claims over the age of 120 days which includes accessing insurance websites, direct calling to insurance companies, contacting patients, writing appeals, and supplying requested documentation, authorizations, and/or referrals when needed.
  • Answers patient phone calls in a timely and professional manner and handles patient inquiries politely and accurately.
  • Prepares refunds as needed for return to patients and insurance companies.
  • Reviews accounts for transfer to collection agency when needed.
  • Reviews statements for proper discounts to self-pay patients.
  • Interacts effectively and professionally with office staff and providers to create teamwork that accomplishes our established goals.
  • Performs other duties as assigned.

QUALIFICATIONS / REQUIREMENTS:

Experience: Minimum 3 years billing experience in a medical office preferred.

Education:

  • High School Diploma
  • Accredited billing school preferred

Licenses / Certifications: Certification in medical billing preferred, but experience can substitute.

Other:

If applicable, the individual performing this job may reasonably anticipate coming into contact with human blood and other potentially infectious materials. Individuals in this position are required to exercise universal precautions, use personal protective equipment and devices, and learn the policies concerning infection control.

  • Knowledgeable in Excel and Word.
  • Epic experience a plus.
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