Job Class:             Biller I-II-III-IV

Department:        9100- Business Office  / 9630- Clinic Management

 

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:

-Must be able to type 30 wpm with computer skills

-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