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Company Name : Peaks Recovery Centers
Location : Colorado Springs, CO 80920
Position : Medical Biller
Job Description : GENERAL PURPOSE: The Medical Biller is part of a multi-disciplinary team that ensures that PRC’s revenue cycle management is reliable, functional, and streamlined to ensure the ideal revenue flow for PRC to account for its monthly payables. This includes coordination with the billing team and private insurance companies for their request of all group/individual clinical notes and any other information requested. All billing will take place daily.ESSENTIAL DUTIES AND RESPONSIBILITIES Works under the supervision and direction of the ControllerCollaborate with the Controller when issues arise that need support e.g. audits, denial of third party contracts, negotiations, etc.Adheres to the Billing Policies and Procedures laid forward by PRCWhere the PnPs become outdated or irrelevant, inform and work collaboratively with the Controller as to what changes need to be made to ensure optimal flow of revenuesWork with Controller to develop PnPs where they are needed and/ or missingResponsible for day-to-day tasks associated with Revenue Cycle Management (RCM); including but not limited to charging, payment posting, A/R, denials, low reimbursements, and audits.Responsible for appealing any and all low reimbursements that do not match historical data or do not match the reimbursement language within the VOB.Check each insurance payment for accuracy and compliance with contract discountResponsible for coordinating billing department needs as they arise across Quality Assurance, Clinical, Medical, and administrative departments under the supervision of the Controller.Work with and communicate with any and all departments to address billing issues.Adheres to attendance, punctuality, and dependability set forth by the company e.g. 40 hours/ wk.Posts payments toward deductible and coinsurance when a patient admits into programmingIdentify and resolve customer and patient billing issues by educating them on our billing practices, how insurance works, and providing a thoughtful/ helpful customer experience.Review accounts regularly for insurance or patient follow-up.Perform and/ or assign various collection actions, which include contacting patients by phone, correcting and resubmitting claims to third party payers, etc.Review patient bills for accuracy and completeness and obtain any missing information.Follow up on unpaid claims within the standard billing cycle time frame.Call insurance companies regarding any discrepancy in payments when necessary.Attend department meetings to achieve unity and cohesion among its members, educate and support staff to increase productivity and efficiency, and work with the Controller to prioritize departmental needs.Verification of Benefits – As needed to act as a backup person when the front desk is not available or when there are inconsistencies within the original VOB that requires a more sophisticated department lens.Participate in interdisciplinary team meetings bi-weekly on Tuesdays at 8:30AM when applicable to your department and/ or to gain understanding of company wide operations on a need-to-know basis.Maintain strict confidentiality, adhering to all HIPAA guidelines/regulations.Maintain that all charts are in correct order and have the necessary paperwork for Colorado state and billing purposes.Handles client’s medical records requests in the absence of support from department employees or alternative department availability.Works directly under the supervision of the Controller.Maintains and requests all clinical updates in conjunction with the Clinical staff on a monthly basis with support of the Controller.Follows all Standard Operating Policies and Procedures of PRC.Demonstrates positive role modeling for the clients and other staff members.Attends all requested/required staff meetings (ex. in-service meetings, peer reviews, supervision sessions, etc.) and trainings.Works cooperatively and constructively as part of an interdisciplinary team.CENTER-WIDE ESSENTIAL DUTIES & RESPONSIBILITIESResponsible for keeping client information confidential by adhering to Colorado state law, HIPAA, and Standard Operating Policies and Procedures of PRC.Responsible for compliance with applicable federal, state and local laws; professional practice acts and ethical guidelines; Standard Operating Policies and Procedures for PRC; and contractual guidelines.Responsible for supporting PRC Mission, Vision, and Purpose, including company values and beliefs by practicing and modeling the company culture.Completes required training and any additional training as requested or selected by supervisorMust possess excellent verbal and written communication, attention to detail, strong work-ethic, effective scheduling and computer skills required.MISC. DUTIES AS ASSIGNED This job description in no way states or implies that these are the only duties to be performed by the employee occupying this position. It is not intended to limit or in any way modify the right of any supervisor to assign, direct, and control the work of employees under his/her supervision. The use of a particular expression or illustration describing duties shall not be held to exclude other duties not mentioned that are of similar kind or level of difficulty.QUALIFICATION REQUIREMENTS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.Education or Formal Training and Experience:High School Degree or equivalent; Bachelor’s Degree Preferred.1+ years of experience with healthcare collections and commercial insurances (BCBS, Humana, Aetna, etc).1+ years of experience in various billing/front office roles.1+ years of A/R experience within a medical billing environment.1+ years of customer service experience.Knowledge, Skill and Ability: Knowledge of ICD-10 and CPT Codes.Excellent verbal and written communication skills to a broad variety of stakeholders.Ability to lead in a supportive, professional manner.Ability to work well with other agencies and businesses in the community.Ability to maintain the highest level of confidentiality.Ability to listen, problem solve, resolve conflict, and be solution focused.Ability to meet due dates, time requirements, and commitments.Ability to communicate clearly and effectively with clients, staff, and the public.Ability to remain open minded and take direction.Ability to travel within the community.Ability to interact with people in a professional, friendly manner.Ability to work independently as well as cooperatively and constructively as part of an interdisciplinary team.Ability to think critically and independently.Ability to realize and activate potential in every interaction, every day.Ability to adapt to change in the workplace.Ability to use change as an opportunity for innovation and creativity.Ability to inspire and model collaborative teamwork.Job Type: Full-timePay: $20.00 – $25.00 per hourBenefits:401(k)Dental insuranceEmployee assistance programHealth insuranceLife insurancePaid time offVision insuranceSchedule:8 hour shiftMonday to FridaySupplemental Pay:Bonus payApplication Question(s):Are willing or have you already received the COVID-19 vaccines?Experience:ICD-10: 1 year (Preferred)Work Location: One location
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