Wyoming County Hiring for Medical Biller Job at Warsaw, NY Full Time

MEDICAL BILLER

DISTINGUISHING FEATURES OF THE CLASS: Performs medical billing; including the processing of Medicare, Medicaid and third party health insurance claims for all divisions of the Wyoming County Community Health System. Incumbents may specialize in billing in one or more areas such as Medicare, Medicaid and third party health insurance and/or secondary insurance coverage. The incumbent performs account keeping, billing and reimbursement tasks that require the interpretation and application of various federal, state, county and institutional regulations. Work involves coding, relating to the reimbursement billing process, follow up with third party payers using a modernized computer billing system. These as well as other duties will be performed as necessary in the Business office under the general supervision of the Business Office Manager. Performs other related duties as required.

TYPICAL WORK ACTIVITIES:

• Reviews and interprets information received from various departments, disciplines, and outside vendors and applies appropriate billing methods in interpreting data using the computer system and will enter additional data into the system as necessary;
• Reviews claims for adjudicated Medicare and/or Medicaid payments to determine the availability of third party insurance;
• Reviews and interprets medical payment remittance advice and assures appropriate application to the patient / resident billing account, reconciling where appropriated;
• Will, as necessary, compute payments for patients who are eligible for Medicare or Medicaid;
• Prepares billing claims, using the current computer system applying current methodology, ensuring completeness and accuracy;
• Verifies and interprets medical coverage with various governmental and commercial insurers and providers as necessary;
• Reviews claim payments and compares to claims submitted and timely follows up on claims that are denied, claims with missing information, problem claims and paid claims with discrepancies;
• Bills appropriate insurers utilizing federally approved billing format in both electronic and paper format as applicable;
• Searches computer databases to obtain data necessary for state and federal reports and/or reimbursement claims;
• Contacts patients/residents, responsible parties, vendors , and other health providers by phone or written correspondence to obtain additional information as necessary;
• Answers telephone, walk-in or written inquires regarding Medicare, Medicaid or health insurance coverage;
• Creates, updates and maintains various patient files and statistical records;
• Prepares a variety of reports and records relating to billing activities;
• Operates a calculator, personal computer and other related office equipment.

FULL PERFORMANCE KNOWLEDGE, SKILLS, ABILITIES AND PERSONAL CHARACTERISTICS:

Good knowledge of the New York State and Federal regulations, including coverage and entitlement criteria, billing rules, beneficiary rights and provider responsibilities; Good knowledge of Medicare, Medicaid and third party health insurance coverage, requirements and procedures; Good knowledge of inpatient, outpatient, mental health and nursing home billing and reimbursement knowledge; Good knowledge of medical billing requirements and procedures; Good knowledge of office terminology, procedures and equipment; Interprets medical insurance coverage and applies interpretations to facility specific medical billing software to crease reimbursement models for specific residents; Ability to manage, analyze and reconcile billing and payment detail; Ability to make more difficult arithmetic computations involving fractions, decimals and percentages accurately; Ability to understand and carry out moderately complex oral and written directions; Ability to perform close, detail work involving considerable visual effort and strain; Ability to develop effective working relationships and deal diplomatically with others; Ability to interpret insurance documents, including insurance cards, policies, payment remittances, etc.; Ability to organize and maintain accurate records and files; Ability to analyze and organize data and prepare record reports and spreadsheets; Ability to operate a personal computer and utilize common software programs including word processing, spreadsheets and databases; Ability and knowledge of using internet located software systems as they related to Medicare, Medicaid and third party insurance verification and billing; MUST maintain the confidentiality and integrity to all medical records; Attention to detail is essential as in problem solving skills; Ability to deal compassionately with individuals; Clerical aptitude, Accuracy, Tact, Courtesy, Good judgment.

MINIMUM QUALIFICATIONS:

(A) Graduation from a high school or possession of a New York State equivalency diploma and one (1) year of direct experience processing or verifying Medicare, Medicaid or commercial insurance claims in a hospital, nursing home, medical facility or long term care facility preferred.

NOTE:

• Successful completion of a medical biller certification program through an accredited educational facility may be substituted for and be equivalent to 3 months of direct experience.
• Successful completion of a medical biller degreed program (Associates Degree or higher) at a regionally accredited college or university may be substituted for and be equivalent to six months direct experience.
• An Associates and/or Bachelor’s Degree from a regionally accredited college or university in a closely related business or medical field may be substituted for and be equivalent to 4 months direct experience.

Competitive

Job Type: Full-time

Pay: $17.10 – $18.82 per hour

Benefits:

• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Paid time off
• Retirement plan

Schedule:

• Day shift
• Monday to Friday

Education:

• High school or equivalent (Preferred)

Experience:

• ICD-10: 1 year (Preferred)
• Medical Billing: 1 year (Preferred)

Work Location:

• One location

Work Remotely:

• No

Work Location: One location