Medical Biller

COMMUNITY HEALTH:

Community Health is a primary care network that provides nationally-recognized programs, a focus on wellness, dental, behavioral health and pediatric specialties, walk-in Express Care, a culture of community and quality health care that almost everyone, insured or uninsured, has come to depend on. As an equal opportunity employer, we offer a team-oriented, collaborative work environment for close to 400 employees at eight different locations in Rutland and southern Addison counties. 

POSITION SUMMARY:

Responsible for gathering charge information, entering charges into the Practice Management system, reconciling billing codes and distributing billing information. 

ESSENTIAL FUNCTIONS:

Essential functions are those tasks, duties and responsibilities that comprise the means of accomplishing the job’s purpose and objectives.  Essential functions are critical or fundamental to the performance of the job.   They are the major functions for which the person in the job is held accountable.  The following are the essential functions of the job.

• Enters billing charges and payments into practice management system.
• Ability to assign CPT/HCPCS/ICD 10 diagnosis codes according to CPT and insurance carrier guidelines.
• Process insurance carrier payments/denials.
• Assists insurance carriers, Community Health staff and patients with billing questions/issues in a professional manner.
• Assists front desk staff with questions regarding unbalanced daily payments reports and registrations.
• Communicates with leader regarding billing issues.
• Ability to contact and work with patients setting up payment plans for Community Health services.
• Prepares daily bank deposit/reports
• Discusses sliding fee scales with patients and helps guides them to appropriate staff for completion.

Medical Biller II Duties:

• Expertise in processing insurance carrier payments/denials.
• Strong knowledge and accuracy in processing charges into practice management system.
• Process strong attention to detail and analytical skills
• Contacts Vermont Health Connect (VHC) to change PCPs for Community Health providers to obtain monthly capitation rates.
• Corrects applications over the phone with VHC.
• Renews applications with VHC for patients that are ineligible.
• Responds to emails and phone calls from billing to schedule navigator appointments for patients who do not have insurance.
• Reviews Medent data for all sites and prepares log for who needs navigator assistance for renewing insurance and or sliding fee scale. Contact VHC to rectify issues.
• Proactively applies for retroactive Medicaid coverage for patients to assist with Community Health medical bills.
• Terminates commercial insurances when a patient no longer has them so Medicaid will be primary payer and denied claims can be reprocessed.
• Add newborns onto Medicaid family accounts.
• Coordinates non-covered claims with DCF for children who were in their custody so claims will be paid.
• Assists patients in applying for Medicaid and or SFS

OTHER DUTIES:

• Other duties as assigned

SKILLS REQUIRED FOR SUCCESS:

• High School Diploma or GED.
• Associates Degree preferred.
• Prior experience in medical coding/billing required
• Knowledge and skills in using the electronic medical record, basic computer skills and use of office equipment, customer service and phone skills, ability to establish and maintain effective working relationships with employees, patients and the public. Ability to work efficiently and accurately in a busy office.

  HOW WE SUPPORT YOU:

• Work Life Balance
• Generous Time Off
• Medical, dental, and vision insurance.
• Health savings account option.
• Robust 403 (b) retirement savings plan, with employer match and 100% vesting schedule.
• Comprehensive Wellness Program.