medical biller

Spine Center of New Jersey

<p><b>Job Overview</b></p><p>IMMEDIATELY CALL ME AND IF I DONT PICK UP THEN LEAVE A TEXT AND A NAME AND STATE YOUR INTENTION. 732-558-3256</p><p>We are seeking a detail-oriented and energetic Medical Biller to join our healthcare team. In this vital role, you will be responsible for managing the billing process for medical services, ensuring accurate and timely submission of claims, and maintaining clear communication with insurance companies, patients, and healthcare providers. Your expertise will help streamline revenue cycle management, improve cash flow, and enhance patient satisfaction. If you thrive in a fast-paced environment and have a passion for healthcare administration, this is an excellent opportunity to contribute to quality patient care through efficient billing practices.</p><p><b>Responsibilities</b></p><ul><li>Prepare and submit accurate medical claims using billing software and electronic health record (EHR) systems</li><li>Review medical records and documentation to ensure proper coding with CPT (Current Procedural Terminology), ICD-9, ICD-10, DRG (Diagnosis-Related Group), and ICD coding standards</li><li>Follow up on unpaid or denied claims promptly to maximize collections and resolve discrepancies</li><li>Communicate effectively with insurance companies to clarify claim issues and obtain pre-authorizations or referrals as needed</li><li>Maintain detailed records of billing activities, payments, adjustments, and patient accounts</li><li>Assist patients with billing inquiries, explaining charges and payment options clearly and professionally</li><li>Stay updated on healthcare claims management regulations, health insurance policies, and coding guidelines to ensure compliance</li></ul><p><b>Requirements</b></p><ul><li>Proven experience in medical billing with familiarity in medical collection processes and healthcare claims management</li><li>Strong knowledge of medical terminology, medical records, and coding systems including CPT, ICD-9, ICD-10, DRG, and ICD coding</li><li>Proficiency in Microsoft Office applications such as Excel and Word, along with experience using billing software and EMR/EHR systems</li><li>Excellent customer service skills with the ability to communicate complex billing information clearly</li><li>Understanding of health insurance policies, benefits verification, and medical office workflows</li><li>Ability to work independently while managing multiple tasks efficiently in a fast-paced environment</li><li>Prior experience in medical office settings or healthcare administration is highly preferred</li></ul><p>Join our team as a Medical Biller and play a crucial role in ensuring smooth financial operations within our healthcare facility. Your dedication will directly impact the quality of patient care by supporting accurate billing practices and effective revenue cycle management. We value energetic professionals committed to excellence in healthcare administration!</p><p>Pay: $15.00 - $22.00 per hour</p><p>Work Location: In person</p>

Medical Biller

TriHealth Inc.

<div><div><b>***Medical Biller I &ndash; TriHealth Norwood***<br>
</b></div><div></div><div>Grow your billing career in a supportive, high‑performing team. As a Medical Biller I, you&rsquo;ll play a key role in ensuring accurate claims, timely reimbursement, and exceptional service for patients and payers - all while building your expertise with industry‑leading systems and ongoing learning opportunities.<br>
</div><div></div><div>Apply today and grow your career with a team that truly values you.<br>
</div><div></div><div><b>Location:
</b></div><ul><li><div>TriHealth Norwood at 4685 Forest Avenue, Norwood, OH 45212<br>
</div></li></ul><div></div><div><b>Work Schedule:
</b></div><ul><li><div>Fulltime (80 hours bi-weekly)
</div></li><li><div>Day Shift
</div></li><li><div>No Weekend, No Holiday No on Call Commitment<br>
</div></li></ul><div></div><div><b>Benefits:
</b></div><div>TriHealth offers a comprehensive benefits package including medical, dental, vision, paid time off, retirement plans, and tuition reimbursement. Please view our benefits page: https://careers.trihealth.com/what-we-offer/benefits<br>
</div><div></div><div><b>Job Requirements:
</b></div><ul><li><div>High School Diploma or GED or GED (Required)
</div></li><li><div>1 - 2 years&rsquo; experience in related field (Required)
</div></li><li><div>Billing and Payer knowledge of Hospital and/or Physician Billing
</div></li><li><div>Working knowledge of ICD-9, ICD-10, and CPT terminology<br>
<br>
</div></li></ul><div><b>Job Overview:
</b></div><div>The entry level Medical Biller's general responsibilities include ensuring timely claim submission, follow up with no response from payers, payer rejections, correspondence, and contract variances and appealing denials based on HB or PB requirements. The biller must ensure proper account documentation in the facility's billing system. Responsible to also provide excellent customer service skills by answering patient and third-party questions and/or addressing billing concerns in a timely and professional manner. Reviews, investigates, and resolves credit balances.<br>
</div><div><br>
<b>Job Responsibilities:
</b></div><ul><li><div><b>Knowledge. </b>Participates willingly in payer communication, team huddles and supports others in sharing information and keeping up to date. Knowledge of systems used to include EPIC, Availity, and all payor portals.
</div></li><li><div><b>Quality Review. </b>Consistently produces quality work and actions to move a claim to proper payment or account resolution while maintaining assigned work queues.
</div></li><li><div><b>Personal Productivity. </b>Completes assigned workload based on key performance indicators daily to ensure standard productivity is met.
</div></li><li><div><b>Patient Accounting Cash. </b>Meets or exceeds approved target; collects 100% of net revenue booked based on remittance.
</div></li><li><div><b>Aging. </b>Decreases AR greater than 90 days for Insurance accounts as set by department each year. Lower is better.<br>
<br>
</div></li></ul><div></div><div>TriHealth SERVE Standards and ALWAYS Behaviors
</div><div>At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following:<br>
</div><div></div><div><b>Serve: ALWAYS...
</b><br>
&bull; Welcome everyone by making eye contact, greeting with a smile, and saying &quot;hello&quot;
<br>
&bull; Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist
<br>
&bull; Refrain from using cell phones for personal reasons in public spaces or patient care areas<br>
</div><div></div><div><b>Excel: ALWAYS...
</b><br>
&bull; Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met
<br>
&bull; Offer patients and guests priority when waiting (lines, elevators)
<br>
&bull; Work on improving quality, safety, and service<br>
</div><div></div><div><b>Respect: ALWAYS...
</b><br>
&bull; Respect cultural and spiritual differences and honor individual preferences.
<br>
&bull; Respect everyone's opinion and contribution, regardless of title/role.
<br>
&bull; Speak positively about my team members and other departments in front of patients and guests.<br>
</div><div></div><div><b>Value: ALWAYS...
</b><br>
&bull; Value the time of others by striving to be on time, prepared and actively participating.
<br>
&bull; Pick up trash, ensuring the physical environment is clean and safe.
<br>
&bull; Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.<br>
</div><div></div><div><b>Engage: ALWAYS...
</b><br>
&bull; Acknowledge wins and frequently thank team members and others for contributions.
<br>
&bull; Show courtesy and compassion with customers, team members and the community<br>
</div><p></p><p>Job keywords:
</p><p>Medical Records Specialist / Medical Records Specialist / Medical Assistant /Emergency Medical Technician / Medical Administrative Assistant</p></div>

Medical Biller I

Community Medical Services

<div>
 <strong>
  Description
  <br/>
  <br/>
 </strong>
 <strong>
  Schedule: hybrid (3 days in office and 2 days remote) after 30 days of in person training
  <br/>
  <br/>
 </strong>
 Reporting to the RCM Manager, Community Medical Services (CMS) is hiring a Senior Medical Biller. This role will be responsible for analyzing, reporting and trending the impact of multi-state and multi-payer AR work processes. The ideal candidate will have experience with Medicaid, Medicare, Veteran Affairs and commercial lines of business. The candidate will also be responsible for managing high volume insurance plans or national contract payers. This role will identify claim denials and payment trends and work directly with payers to resolve using projects and appeals processes.
 <br/>
 <br/>
 As part of our mission to help individuals recover from substance use disorders, you&rsquo;ll thrive in a supportive, engaging, and fulfilling work environment where your contributions are valued.
 <br/>
 <br/>
 Along the way, we&rsquo;ll invest in your well-being through a benefits package that includes:
 <br/>
 <br/>
 <ul>
  <li>
   Subsidized medical, dental, and vision insurance
  </li>
  <li>
   Health savings account
  </li>
  <li>
   Short and long-term disability insurance
  </li>
  <li>
   Life insurance
  </li>
  <li>
   Paid sick, vacation, and holiday time
  </li>
  <li>
   401K retirement plan with match
  </li>
  <li>
   Tuition and CME reimbursement up to 100%
  </li>
  <li>
   Employee assistance program to support your mental health and wellness
  </li>
  <li>
   Ongoing professional development
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Responsibilities
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Experience with Medicaid, Medicare, Veterans Affairs and Commercial line of business.
  </li>
  <li>
   COB processing.
  </li>
  <li>
   Independently analyzing and reporting the impact of existing AR work processes.
  </li>
  <li>
   Managing high volume insurance plans or national contract payers.
  </li>
  <li>
   Monitor claim volume and payments for assigned payers to maintain accuracy.
  </li>
  <li>
   Assist with developing new processing steps for managing AR.
  </li>
  <li>
   Remain current on multi-state billing and coding procedures and changes.
  </li>
  <li>
   Excellent communication skills.
  </li>
  <li>
   Work with cross functional Community Medical Services Teams, like Clinical Operations, Quality Management, and Credentialing.
  </li>
  <li>
   Problem solver, using data driven decision making.
  </li>
  <li>
   Detail orientation with the ability to handle multiple assignments promptly and effectively.
  </li>
  <li>
   Experienced with using Microsoft Windows, Outlook, Word, Excel.
  </li>
  <li>
   Other duties as deemed necessary to include finance responsibilities.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Qualifications
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   5-7 years full cycle medical billing experience required
  </li>
  <li>
   HS Diploma or GED required
  </li>
  <li>
   Billing certification a plus
  </li>
  <li>
   Strong Knowledge of CPT/ICD10 coding, insurance cards, and medical benefits.
  </li>
  <li>
   Run and utilize weekly aging AR reports to follow up on outstanding claims, and bulk process for claim resolution
  </li>
  <li>
   Ability to handle multiple projects independently and adhere to deadlines
  </li>
  <li>
   Experience with Kipu a plus
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Tools And Equipment Requirements
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Ability to use a phone, computer, printer, and copier is required
  </li>
  <li>
   Frequent use of Microsoft Office products (Word, Excel, PowerPoint, etc.)
  </li>
  <li>
   Ability to use the internet and various web browser software is required
  </li>
  <li>
   Frequent use of electronic health record to document patient encounters
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Physical Working Conditions
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Requires sitting, standing, and bending associated with a office environment
  </li>
  <li>
   Some lifting may be required
   <br/>
   <br/>
  </li>
 </ul>
 #CRPSF
 <br/>
 <br/>
 <strong>
  Requirements
  <br/>
  <br/>
 </strong>
 <strong>
  About Community Medical Services
  <br/>
  <br/>
 </strong>
 Community Medical Services (CMS) is a CARF-accredited addiction treatment program providing services in the form of outpatient medication-assisted treatment and one-on-one and group counseling to those seeking help with their opioid use disorder. Headquartered in Arizona with more than 70 treatment clinics in 14 states, CMS is dedicated to meeting the challenges presented by the growing opioid epidemic in communities where treatment is lacking.
 <br/>
 <br/>
 <strong>
  Our Commitment
  <br/>
  <br/>
 </strong>
 We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sex, disability status, sexual orientation, gender identity, age, protected veteran status or any other characteristic protected by law. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
 <br/>
 <br/>
 <strong>
  Other Conditions
  <br/>
  <br/>
 </strong>
 Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
</div>


Sr Medical Biller

Aire Medical Group

<p>Los Angeles Food Allergy Institute / AllergyDox &ndash; Burbank, CA</p><p>Job Summary</p><p>We are seeking a highly experienced, detail-oriented, dependable, and proactive Senior Medical Billing Specialist to join our growing Allergy/Immunology practice in Burbank, California. The ideal candidate will have extensive experience with medical billing, insurance follow-up, accounts receivable management, denial resolution, payment posting, and experience working within the Tebra (Kareo) EHR/Practice Management system.</p><p>This position is best suited for someone who can independently manage accounts receivable, insurance follow-up, denials, and payment posting within a fast-paced specialty medical practice. We are looking for a strong team member who is organized, accountable, professional, and capable of managing multiple priorities with minimal supervision.</p><p>Responsibilities</p><ul><li>Verify billing information, insurance details, rates, coding, and supporting documentation for accuracy.</li><li>Submit and follow up on insurance claims in a timely manner.</li><li>Monitor accounts receivable and work aging reports to ensure prompt payment collection.</li><li>Follow up on denied, rejected, and no-response claims with insurance carriers.</li><li>Investigate and resolve billing discrepancies, payment issues, and patient billing inquiries professionally and efficiently.</li><li>Process payment posting, adjustments, refunds, and credit balances accurately.</li><li>Review ERAs/EOBs and ensure proper reconciliation of payments.</li><li>Work closely with management and clinical staff to resolve billing-related issues.</li><li>Maintain accurate billing and patient account records while safeguarding confidential information.</li><li>Identify areas for workflow improvement to enhance billing accuracy and operational efficiency.</li><li>Assist with patient balance follow-up and collections.</li><li>Ensure compliance with HIPAA regulations, payer guidelines, and office policies.</li><li>Perform additional administrative, billing, and accounting duties as assigned.</li></ul><p>Preferred Qualifications</p><ul><li>High school diploma or equivalent required.</li><li>Associate&rsquo;s or Bachelor&rsquo;s degree in Accounting, Finance, Business, Healthcare Administration, or related field preferred.</li><li>Minimum of 2 years of experience working with Tebra (Kareo) EHR/Practice Management system strongly required.</li><li>Minimum of 5 years of stable medical billing and accounts receivable experience with one company required.</li><li>Experience with PPO, HMO, Medicare, Medi-Cal, and IPA claims is required.</li><li>Strong understanding of insurance follow-up, denials management, payment posting, and accounts receivable processes.</li><li>Proficiency in Microsoft Excel and billing/accounting software.</li><li>Excellent organizational skills and strong attention to detail.</li><li>Strong analytical, problem-solving, and critical-thinking abilities.</li><li>Excellent verbal and written communication skills.</li><li>Ability to prioritize multiple tasks and meet deadlines in a fast-paced environment.</li><li>Allergy/Immunology or specialty medical office experience is preferred.</li></ul><p>Compensation</p><ul><li>$37&ndash;$42 per hour, depending on experience and qualifications.</li><li>Compensation will be based on specialty billing knowledge, Tebra (Kareo) proficiency, insurance follow-up experience, denial management experience, and overall medical billing/accounts receivable background.</li></ul><p>Schedule</p><ul><li>Full-time</li><li>Monday&ndash;Friday</li><li>8:00 AM &ndash; 5:00 PM</li></ul><p>Benefits</p><ul><li>401(k)</li><li>Paid sick time</li><li>Paid vacation</li><li>Retention Bonus</li><li>Opportunities for growth and advancement</li><li>Supportive team environment</li></ul><p>Work Location</p><p>In-person<br/>Burbank, California</p><p>Additional Information</p><p>We are looking for someone who is highly reliable, professional, and committed to long-term growth within our company. The ideal candidate should be a strong team player with excellent work ethic, good moral values, professionalism, respect toward patients and coworkers, and a positive attitude. We value individuals who are accountable, dependable, proactive, organized, and motivated to grow with our practice long term.</p><p>Pay: $37.00 - $42.00 per hour</p><p>Benefits:</p><ul><li>401(k)</li><li>Employee discount</li><li>Paid time off</li></ul><p>Experience:</p><ul><li>Medical billing: 4 years (Required)</li></ul><p>License/Certification:</p><ul><li>Medical Billing Certification (Required)</li></ul><p>Work Location: In person</p>

Senior Medical Biller

Supportive ABA Therapy

<div><p>We're looking for a detail-oriented ABA Biller to join our revenue cycle team. You'll handle claim submissions for ABA therapy services, manage denials and appeals, verify authorizations, and ensure billing compliance across Medicaid and commercial payers. The ideal candidate has 2+ years of medical billing experience, including at least 2 year in an ABA setting, and is familiar with ABA-specific CPT codes and platforms like CentralReach. We offer competitive pay, full benefits, and a supportive, mission-driven team. Apply today to make an impact in the lives of those we serve.</p><ul><li><p>
Full time in office position</p></li><li><p>
Medical, Dental, and vision insurance.</p></li><li><p>
Supportive work environment and growth oppurtunities.</p></li><li><p>
Central Reach Experience Required</p></li></ul></div>

ABA Medical Biller (Hollywood office)

StoneGate Senior Living

<p>Insurance Biller<br/></p><p>100% On Site<br/></p><p>StoneGate Senior Living<br/></p><p>Lewisville, TX<br/></p><p>StoneGate Senior Living, a leading provider of Long-Term Care, Skilled Nursing and Rehabilitative Care in Lewisville, TX has an opportunity for an Insurance Biller with Managed Care Insurance experience to join our team! A rewarding career is waiting for you with a company that specializes in long-term and rehabilitative care! If you are an experienced Insurance Biller with Managed Care experience, we have the opportunity for you. This is not a remote position.<br/></p><p>As the Insurance Biller you are responsible for verifying, facilitating insurance authorizations, and billing via UB04s for Skilled Nursing patients. Duties may also include communicating with clinical liaisons, insurance carriers, and Skilled Nursing Facilities. The specialist will verify patients&rsquo; demographics, gathering and recording pertinent information, conform insurance/payor benefits, review preauthorization and complete processes and bill inpatients to the Skilled Nursing Facilities. Follow-up on all claims, moving copays, posting cash, appeals for non-paid claims and work all balances.<br/></p><p>Come be a part of our mission to provide superior clinical care, rehabilitation, wellness, and supportive services that meet the wants, needs, and expectations of our patients and residents. We offer competitive compensation, health, dental, and vision insurance, company paid life insurance, holiday pay, paid time off, employee appreciation events and much more. We look forward to you joining our team!<br/></p><p>Responsibilities:<br/></p><p>Understanding of SNF billing requirements and systems.<br/></p><p>Bills Insurance via UB04 detailed billing, non-episodic<br/></p><p>Tie NOMNCs to Insurance Authorization for billing and appeals.<br/></p><p>Full understand of ISNP systems and ability to bill per guidelines<br/></p><p>Detailed UB04/837 understanding<br/></p><p>Manage large load of claims from multiple facilities within deadlines<br/></p><p>Work closely with Team Members and billing issue resolutions<br/></p><p>Communicates effectively with clinical reimbursement<br/></p><p>Knowledge/understanding of Pharmacy exclusions and related billing procedures<br/></p><p>Post incoming remits and balance books<br/></p><p>Understand basic accounting knowledge and processes<br/></p><p>Working knowledge of national insurance clearing house systems<br/></p><p>Contact patient&rsquo;s insurance to confirm and determine amount of coverage and benefits, deductible due, length of stay and if authorization is required.<br/></p><p>Communicates authorization status electronically and verbally if needed. .<br/></p><p>Maintains open communication with Team Members and Clinical Liaisons to ensure teamwork, cooperation and mutual respect.<br/></p><p><b>**</b><b>This is not a Coder position</b><b>**</b>**<br/></p><p>Requirements:<br/></p><p>High school diploma. College degree in Business preferred<br/></p><p>Basic Accounting/bookkeeping skills needed.<br/></p><p>UB04 experience required<br/></p><p>Must have Managed Care Insurance experience.<br/></p><p>Experience in Skilled Nursing authorizations preferred.<br/></p><p>Strong knowledge and understanding of Medicare, Managed Care, HMO/PPO plans and authorization/referral requirements.<br/></p><p>Ability to understand medical terminology.<br/></p><p>Ability to multi-task and prioritize duties.<br/></p><p>Strong Excel skills<br/></p><p>Excellent organizational skills.<br/></p><p>Uses a computer proficiently.<br/></p><p>Speaks and communicates English effectively, both in verbal and written format.<br/></p><p><b>**</b><b>Note: this is NOT a coder position</b><b>**</b><br/></p>

Insurance Biller

Avanti Hospitals

<div><p><b>Job Summary:</b></p>
<p>
Responsible for timely billing and follow up for all acute care Medicare claims according to State and Federal regulations. Reviews and resolves credit balances. Works all denials and or rejections from the billing work ques timely. Submits accurate contractual adjustments and proper documents each account. Responsible for inputting accurate data into excel spreadsheets. Pull data for audits and assist with special projects and or backlogs within the office. Actively and consistently contributes to department operations and communications, behaves in a manner consistent with the mission, vision, and values of Pipeline Health, upholding standards of AIDET (Acknowledge, Introduce, Duration, Explanation, Thank you) patient communication.</p>
<p>
Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.</p>
<p><b>
Pharmacy Biller/Collector-</b></p>
<p>
Responsible for timely billing and follow up for all Part &ldquo;D&rdquo;, Sub-Acute/SNF patients. Works all denials and or rejections in a timely manner. Works incoming correspondence. Works closely with the Pharmacy departments relating to the drugs and formulas. Actively and consistently contributes to department operations and communications, behaves in a manner consistent with the mission, vision, and values of Pipeline Health, upholding standards of AIDET (Acknowledge, Introduce, Duration, Explanation, Thank you) patient communication.</p>
<p><b>
Essential Functions:</b></p>
<ul>
<li>Knows how to download CMS/Epremise system daily or as needed.</li>
<li>Monitors &amp; processes credit balances for refunds and transfers in accordance with department procedures.</li>
<li>Processes daily bills via CMS/Epremise system.</li>
<li>Process claims and bills to payors through bill editor in accordance with department procedures.</li>
<li>Knowledge in printing the Remittance Advices.</li>
<li>Works on denial accounts daily or as needed.</li>
<li>Works on daily rejection daily or as needed.</li>
<li>Works on daily mail and correspondence.</li>
<li>Responsible for working off the work ques and clearing ticklers efficiently.</li>
<li>Maintains quality control on all accounts for correct plan ID&rsquo;s and financial class. Updates system with appropriate changes.</li>
<li>Sends requests to ancillary departments for reports needed to bill claims in a timely manner.</li>
<li>Responsible to keep current with updates and changes within the Medicare m via CMS website.</li>
<li>Responsible to retrieve any patient information from the HBF system.</li>
<li>Processes daily contractual adjustments. &amp; calculates payment and contractual adjustment according to expected reimbursement.</li>
</ul><ul><li>Works and resolves aged accounts.</li>
<li>Identifies under and over payments.</li>
<li>Ensures each account has detailed documentation as required by the department procedures.</li>
<li>Meets productivity requirements daily.</li>
<li>Provides Medicare RA&rsquo;s to cross over biller.</li>
<li>Prepares credit balance reporting every quarter to Medicare.</li>
<li>Demonstrates ability to reach decisions takes appropriate action and follow through within scope of responsibility, as defined by job description.</li>
<li>Processes secondary billing and transfers in accordance with department procedures.</li>
<li>Performs all other duties and special projects as assigned.</li>
<li>Basic unit/department maintenance such as keeping files, drawers, cabinets free from unnecessary clutter.</li>
<li>Abides by HIPAA (Health Insurance Portability and Accountability Act) regulations.</li>
<li>Completes and attends monthly training assigned.</li>
</ul>
<p><b>Pharmacy Biller/Collector-</b></p>
<ul>
<li>Prepare Pharmacy billing forms for all sub-acute/SNF patients.</li>
<li>Create and maintain patient files for all information and billing records.</li>
<li>Prepare and update Drug Order Reference sheets for all sub-acute/SNF patients.</li>
<li>Obtain Drug Profile for all affected patients from the pharmacy and reconcile with patient records for billing purposes.</li>
<li>Obtain, update, and reconcile patient census including discharges and admissions with all billing records.</li>
<li>Obtain and maintain current billing manuals and books.</li>
<li>Review and reconcile Hospital Drug Formulary with actual items on pharmacy stock to ensure accurate billing of utilized medications.</li>
<li>Obtain and maintain current prescribing physician&rsquo;s information including license #s, DEA #s, Telephone contact information etc.</li>
<li>Prepare and update Drug Price Lists.</li>
<li>Prepare and perform monthly update of Medi-Cal Drug Provider and policy manual (part 1 &amp; 2)</li>
<li>Complete and transmit electronic billing for Medi-Cal drug approved medications used by SNF/sub-acute care patients.</li>
<li>Maintain accurate records of all billings in individual patient files for any review purposes.</li>
<li>Work with the Pharmacist to complete TAR's for all required drugs utilized by patients.</li>
<li>Fill out correctly and submit by mail all manual/hard copy drug/pharmacy billing to Medi-Cal</li>
<li>Follow up with Medi-Cal office on billing issues to ensure accurate reimbursements.</li>
<li>Obtain, review, and maintain copies of the remittance advice details and follow-up on any inaccuracies with the Medi-Cal office for resolutions.</li>
<li>Create and maintain records of total daily billing amounts.</li>
<li>Create and update Annual Billing totals for each facility.</li>
<li>Communicate changes in patient/Medi-Cal drug coverage with Pharmacist.</li>
<li>Obtain supervisory approval to attend relevant posted educational billing seminars to keep up with the current trends.</li>
<li>Resolve DUR Medi-Cal inquiries with the Pharmacist for affected drugs/ patients prior to re-submission of relevant billings.</li>
<li>Provide Pharmacy check-write to business office Director every Monday.</li>
<li>Performs all other duties and special projects as assigned.</li>
<li>Basic unit/department maintenance such as keeping files, drawers, cabinets free from unnecessary clutter.</li>
<li>Abides by HIPAA (Health Insurance Portability and Accountability Act) regulations.</li>
<li>Completes and attends monthly training assigned.</li>
</ul>
<p><b>Behavioral Standards:</b></p>
<ul>
<li>Exhibits customer and service-oriented behaviors in everyday work interactions.</li>
<li>Demonstrates a courteous and respectful attitude to internal workforce and external customers.</li>
<li>Communicates accurately and appropriately.</li>
<li>Works well and efficiently under minimal supervision.</li>
<li>Handles difficult situations in a discreet and professional manner.</li>
<li>Is adaptable to changes in assignments and priorities.</li>
</ul>
<p><b>Communication/Knowledge:</b></p>
<ul>
<li>Wears nametag properly; follows dress code policy; answers phone correctly and promptly; is prepared for meetings; meets deadlines; does not participate in gossip; acts ethically and treats others with respect; respects customer&rsquo;s and co-worker&rsquo;s time; establishes and maintains effective relationships with customers and co-workers.</li>
<li>Provides accurate and timely written and verbal communication of information in a manner that is understood by all.</li>
<li>Able to listen, understand, problem-solve, and carry-out duties to ensure the optimal outcome.</li>
<li>Able to use IT systems in an accurate and proficient manner.</li>
</ul>
<p><b>Collaboration/Teamwork:</b></p>
<ul>
<li>Contributes toward effective, positive working relationships with internal and external colleagues.</li>
<li>Demonstrates cooperation, flexibility, reliability, and dependability in all daily work activities and a willingness to collaborate with others for the good of the customer and the organization.</li>
</ul>
<p><b>Qualifications:/Experience:</b></p>
<ul>
<li>At least two (2) to three (3) years of current experience in an acute care hospital setting, preferred.</li>
<li>Computer skills preferred.</li></ul><p></p><h4 class="jobSectionHeader"><b><br>
Licenses &amp; Certifications</b></h4>
Preferred<ul><li>
WPV Tier I</li></ul><p>
Equal Opportunity Employer<br>
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.</p></div>

Government Pharmacy Biller-Collector Per Diem Day Shift

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