Biller III

This is a fully remote position, open to applicants in Arizona, +21 more states.

📋 Description

• Process hospital medical claims in compliance with federal, state, and payer-specific guidelines.

• Investigate, analyze, and review errors and rejections in hospital claims, implementing necessary corrections.

• Ensure accurate submission and payment of hospital claims by reviewing and rectifying claim edits, errors, and denials.

• Keep abreast of payer updates and process changes to guarantee precise claims handling.

• Conduct investigations, follow up with payers, and manage assigned claims effectively.

• Identify reasons for non-covered charges and take suitable actions.

• Execute posting of billing adjustments as required.

• Ensure timely processing of billing reroutes in accordance with company protocols.

• Elevate any stalled hospital claims to the manager for resolution.

• Recognize and relay payer-specific issues to both the team and leadership.

• Engage in and contribute to daily shift briefings.

• Adhere to productivity benchmarks while maintaining a high level of quality.

• Handle claims for various clients and systems.

• Carry out other assigned job responsibilities as necessary.

⛳️ Requirements

• High school diploma or equivalent is required; an Associate degree is preferred.

• A minimum of 4 years of experience working with health insurance companies to secure payment for medical claims.

• At least 3 years of experience in billing hospital claims and filing appeals with health insurance providers.

• Familiarity with clearing house systems such as Waystar, Quadex, SSi, or similar billing platforms.

• Proficient in Microsoft Office Suite, Teams, and various desktop applications.

• Understanding of coding guidelines relevant to claim errors.

• Knowledge of Healthcare Revenue Cycle administration rules and regulations.

• Familiarity with ICD-10 diagnosis and procedure codes as well as CPT/HCPCS codes.

• Strong investigative abilities to determine and resolve reasons for non-payment on medical accounts.

• Experience with GoToMeeting/Zoom platforms.

• Capability to make informed decisions and take necessary actions.

• Adaptability to change and ability to perform duties with sound ethical judgment.

• Demonstrates accountability, responsibility, and achievements within the revenue cycle process.

• Candidates will undergo criminal background checks, employment verification, and government exclusion checks as part of the employment process.

🏝️ Benefits

• Paid time off.

• 401(k) plan.

• Health insurance (medical, dental, and vision).

• Life insurance.

• Paid holidays.

• Opportunities for training and development.

• Wellness support.

• Work-life balance support.