Medical Biller

Description

Our Williamsville, NY office is seeking a detail-oriented Medical Biller to join our growing team. This hybrid role requires only one in-office day per week after training. 

Roswell Park Care Network is a recognized leader in oncology and specialty care, serving community physician practices across New York State. We are committed to delivering exceptional patient care and advancing innovative treatment options 

We offer an excellent benefit package: 

• Schedule is Monday through Friday 
• Generous Vacation and Sick time
• 11 Holidays
• Medical Insurance via Highmark Blue Cross Blue Shield
• HRA - employer funded
• Dental Insurance and Vision Insurance
• 401(k) with company match
• Company paid life insurance, options for LTD, Critical Illness, Accident
• Dental Insurance and Vision Insurance

As the Medical Biller, you are responsible for entering charges and submitting medical claims to insurance companies. In addition, you will work all open accounts for insurances and patient related A/R and attend to all patient and insurance-related inquiries. 

  Responsibilities:  

• Prepares, reviews, and transmits claims, both electronic and paper.
• Follows up on unpaid claims within the Billing Department policy timeframe.
• Checks and posts each insurance payment manually or electronically within the Billing Department policy timeframe.
• Calls insurance companies regarding discrepancies in payments if necessary.
• Identifies and bills secondary or tertiary insurances.
• Reviews accounts in patient follow-up.
• Reviews EOBs, appeals and tracks denied claims when necessary.
• Answers all patient, insurance, or staff telephone inquiries pertaining to assigned accounts
• Coordinates with front desk or verification team to ensure active insurance coverage prior to billing.
• Collaborates with other medical coders to clarify diagnosis and procedure codes when discrepancies arise.
• Reconciles submitted claims against remittance advice to identify underpayments or incorrect adjustments.
• Submits and monitors claim status via clearinghouse platforms; addresses rejections in a timely manner.
• Ensures compliance with HIPAA, payer guidelines, and internal billing policies.
• Other additional duties that may be pertinent to the billing department processes.
• Sets up payment plans and works collections if assigned.
• Balances all daily receipts and runs final end of day report.
• Runs and manages open item aging reports bi-weekly for patients and insurances.
• Assists with internal audits and supports quality improvement initiatives in the billing process.

Requirements

 Education/Experience:  

•  High school diploma or G.E.D. and the equivalent of one year of full-time clinical or administrative health care experience
• Minimum of one year of experience in a medical billing role, preferably in a multi-specialty or oncology environment
• Experience with the electronic and paper systems used in billing services
• Experience working in Windows and with MS Office software

Certifications/Licenses:

•  Certified Professional Biller (CPB), Certified Billing and Coding Specialist (CBCS), or equivalent preferred.