BILLER I

Role Details

Job Class: Biller I-II-III-IV

Department: 9100- Business Office / 9630- Clinic Management

CORE DUTIES AND RESPONSIBILITIES

Demonstrates Competency in the Following Areas :

GENERAL FUNCTION:

This training position is accountable for learning how to process all commercial insurance claims accurately and timely on 1500 and UB04 forms. Commercial insurance claims include: Blue Cross, Workmen’s Comp, HMO & PPO insurances, Champus, Contractual policies, etc… Timely follow-ups on claims to ensure payments are received.

JOB DUTIES:

-Maintain established policies and procedures, objectives, quality assurance program and safety standards.

-Research all information to complete billing process.

-Accurate filing of all claims.

-Answer any inquiries regarding billing of accounts.

-Maintain department records, reports, and files as required.

-Participate in educational programs and in-service meetings.

-Perform other job duties as assigned or requested.

MINIMUM QUALIFICATIONS:

-Must be able to type 30 wpm with computer skills

-Must be able to read and write and have good communication skills

-Billing experience preferred

TRAINING TIERS

A Biller I is considered a trainee. A trainee has three (3) months in which to demonstrate competency on three (3) of the following skills. Should the trainee not meet this goal, they may be transferred to a lesser position, retrained or terminated

• Create Encounter

• Key Changes

• Verify Insurance

• Release Charges

• Correct Rejections

• Answer Phones

  A Biller I/Trainee has six (6) months in which to demonstrate competency in all of the above areas. Once demonstrated, trainee will be moved to a Biller II. Should the trainee not meet this goal, they may be transferred to a lesser position or terminated.

  A Biller II has six (6) months from becoming a Biller II to demonstrate competency in three (3) of the following skills:

• AR Follow Up

• Work Denials

• Review Claims and make necessary corrections

• Follow up on insurance

• Make Corrections

  The Biller II will be moved to a Biller III. Should the Biller II not meet this goal, they may be transferred to a lesser position or terminated.

  A Biller III has six months from becoming a Biller III to demonstrated competency in all areas listed for the Biller II. A Biller III will be moved to a Biller IV when all areas are mastered.

  CONTACTS:

  -Within organization—all departments

South Central Regional Medical Center provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.