JOB TITLE: BillerGENERAL SUMMARY OF DUTIES: Performs all billing for primary and secondary insurances for Gold Coast Surgicenter.Interacts with business office staff and facility staff as needed to obtain information necessary to submit a clean claim to insurance carriers.
- Resolve claim edits/exclusions
- Understanding billing guidelines and payor requirements.
- Perform prior authorization functions as needed
- Follow-up on unpaid claims to ensure prompt payment based on aging
- Appeal unprocessed and/or unpaid claims to the appropriate insurance carrier;
EDUCATION/EXPERIENCE:
- Two or more years experience in billing and collections in an ASC, preferably
- High School, with 1-2 years experience in healthcare insurance billing and verification, collections, and/or authorizations, appeals
- Partner with AR team members, facility, vendor, and another third party to ensure all documentation needed for billing and collections is achieved.
- Follow up on claims, resolution of billing issues and collaborate with AR Manager and Team Lead for claims denials and appeals in a timely manner.
QUALIFICATIONS:
- Strong interpersonal and organizational skills
- Knowledge of medical terminology and Knowledge of CPT/ICD-10
- Knowledge or medical billing/claim submission procedures
- Billing/coding certification preferred;
- Insurance appeal experience.