CORE DUTIES AND RESPONSIBILITIES
Demonstrates Competency in the Following Areas:
GENERAL FUNCTION:
This training position is accountable for learning how to process all commercial insurance claims accurately and timely on 1500 and UB04 forms.  Commercial insurance claims include:  Blue Cross, Workmen’s Comp, HMO & PPO insurances, Champus, Contractual policies, etc… Timely follow-ups on claims to ensure payments are received.
JOB DUTIES:
-Maintain established policies and procedures, objectives, quality assurance program and safety standards.
-Research all information to complete billing process.
-Accurate filing of all claims.
-Answer any inquiries regarding billing of accounts.
-Maintain department records, reports, and files as required.
-Participate in educational programs and in-service meetings.
-Perform other job duties as assigned or requested.
MINIMUM QUALIFICATIONS:s
-Must be able to read and write and have good communication skills
-Billing experience preferred
 
TRAINING TIERS
A Biller I is considered a trainee. A trainee has three (3) months in which to demonstrate competency on three (3) of the following skills. Should the trainee not meet this goal, they may be transferred to a lesser position, retrained or terminated

Create Encounter Key Changes Verify Insurance Release Charges Correct Rejections Answer Phones

A Biller I/Trainee has six (6) months in which to demonstrate competency in all of the above areas. Once demonstrated, trainee will be moved to a Biller II. Should the trainee not meet this goal, they may be transferred to a lesser position or terminated.
 
A Biller II has six (6) months from becoming a Biller II to demonstrate competency in three (3) of the following skills:

AR Follow Up Work Denials Review Claims and make necessary corrections Follow up on insurance Make Corrections

The Biller II will be moved to a Biller III. Should the Biller II not meet this goal, they may be transferred to a lesser position or terminated.
 
A Biller III has six months from becoming a Biller III to demonstrated competency in all areas listed for the Biller II. A Biller III will be moved to a Biller IV when all areas are mastered.
 
CONTACTS:
-Within organization—all departments
-Outside organization—insurance companies, doctor offices, nursing homes, patient employers, vocational rehabilitation, and welfare department.
DECISION MAKING:
-Decision taken to supervisor for approval:

ETO Time Clarification of changes of a procedure