Responsibilities:
Position Summary:
The Biller is responsible for the accurate and timely submission and follow-up of Managed Care and Commercial insurance claims for the Psychiatric Division. This role includes oversight of claim transmissions, follow-up with third-party payers, account reconciliation, and patient billing inquiries. The Biller ensures compliance with all regulatory billing guidelines and supports revenue cycle efficiency through accurate documentation and proactive follow-up.
Key Responsibilities:
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Submit and follow up on all Managed Care and Commercial insurance claims for psychiatric services.
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Monitor daily transmittal, acceptance, and error reports to ensure accuracy and timeliness of electronically submitted claims.
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Correct and resubmit claims via EMR or other claim correction tools as required.
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Manually submit all secondary insurance claims that do not transmit electronically after Medicare payment.
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Follow up with secondary third-party payers to confirm claim receipt and obtain status updates.
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Process refunds as necessary, ensuring accuracy and documentation.
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Respond professionally to patient billing inquiries in a timely and courteous manner.
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Maintain accurate and up-to-date records and documentation, including patient folders and remittance advices.
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Review and reconcile patient accounts following Managed Care and Commercial insurance claims payments.
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Verify that clinical summaries align with billing details to ensure accurate claims submission.
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Review and follow up on items listed in the monthly Aged Trial Balance.
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Maintain and update the Bad Debt Log in accordance with department procedures.
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Bill secondary self-pay accounts to patients through the full dunning cycle.
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Ensure that all financial information in patient folders is complete and accurate upon check-in from the division.
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Assist in other related or emergency duties as assigned by supervisor or leadership.
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Support the billing department in achieving overall compliance and performance goals.
Qualifications:
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High School Diploma or GED required; Associate’s degree in Accounting, Business, or Healthcare Administration preferred.
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Minimum 2 years of medical billing experience, preferably in a psychiatric or behavioral health setting.
