Colorado Retina Associates
Full Cycle Biller (Administrative)
Pay Range: $22.14 - 35.42
Job Type: Full Time - Hybrid
Position Summary:
The Full Cycle Biller is responsible for resolution of outstanding A/R including correcting billing errors, refiling claims, appealing denials, and posting approved adjustments. The position requires accuracy, thoroughness, and a good understanding of insurance procedures for referrals, authorizations, copays, and deductibles, as well as Local Coverage Determinations and/or National Coverage Determinations, payer reimbursement guidelines, payer portals, and appeals processes. The Full Cycle Biller will respond to patient balance inquiries, provide patient education (insurance coverage and balances as needed), contact patients about outstanding balances, set payment plans, accept & process payments and discuss financial hardship discounts as appropriate. Work is multi-task based with heavy phone and/or online payer portal activity. Must be able to communicate effectively with patients, physicians, and co-workers.
Job Duties:
Demonstrate thorough understanding of insurance regulations, guidelines, benefits, coverage, and reimbursement policies
Demonstrate thorough understanding of patient financial responsibilities and Fair Debt Collections guidelines
Review and follow-up on unpaid balances, appeal denials and manage other insurance communications
Post appropriate adjustments and approved write-offs
Review and work patient and insurance credit balances
Contact patients by phone, patient portal, text and email about past due balances
Initiate payment plans with patients when necessary
Initiate Financial Hardship application process with patients when necessary
Answer patient billing questions by phone, email and through patient portal
Meet productivity measures assigned by the Supervisor
Communicate to management, peers and providers (as necessary) all payer changes in reimbursement and coverage
Maintain current knowledge of proper coding and billing procedures.
Communicate effectively with physicians, administration, other personnel and patients.
Ability to work independently without direct supervision.
Attend all required meetings/seminars
Other duties as assigned.
Job Requirements
High School Diploma or GED
Three years' recent experience in Medical A/R follow-up; five years' experience is preferred.
Strong understanding of commercial health insurance, and federal and state coverage
Understanding of medical terminology, claims processing guidelines, and federal insurance regulations is required
EMR/PM experience is required, experience with NextGen preferred.
Moderate Excel skills
Good verbal and written communication skills
Certificates & Licenses:
Medical billing and/or coding certification preferred
Our benefits include:
Competitive salary
Safe harbor/profit sharing plan
Full medical, dental, and vision insurance eligible
Pet insurance
Legal, life, accident, disability, and hospitalization insurance