Medical Biller II

Job Overview:

The level II Medical Biller's general responsiblities include assisting the lead medical biller and fellow billing staff in submitting accurate clean claims, ensuring timely follow up. Collaboration with other teams will be needed to ensure denied claims are appealed as needed. Medical Biller II should be cross trained to work different payers to help assist other billing staff. Reviews, investiges, and resolves credit balances. Medical Biller II will ensure the proper documentation in the facility's billing system. Responsible also to provide excellent customer service skills by answering patient and third party questions and/or addressing billing concerns in a timely and professional manner.

Job Requirements:

High School Diploma or GED or GED (Required)
3 - 4 years experience in related field (Required)
Billing knowledge that includes: ICD-9, ICD-10, and CPT terminology 
Epic and Clearing House experience 
Working knowledge of insurance policies and appeals Consistently meets 
individual productivity incentive standards

Job Responsibilities:

Knowledge. Works with little supervisory oversight and exercises appropriate judgement in identifying payer trends. Identifies and appropriately communicates process improvement with team lead and supervisor in a timely manner. Maintains a close working relationship with all departments and consolidates efforts to ensure appropriate and standardized coding/billing procedures are followed. 
Quality Review. Consistently produces quality work and actions to move a claim to proper payment or account resolution while maintaining assigned work queues. 
Personal Productivity. Completes assigned workload based on key performance indicators on a daily basis to ensure standard productivity is met. 
Patient Accounting Cash. Meet or exceed approved target; collect 100% of net revenue booked based on remittance. 
Aging. Decrease AR greater than 90 days for Insurance accounts as set by department each year. Lower is better.

Working Conditions:

Climbing - Rarely 
Concentrating - Consistently 
Continuous Learning - Frequently 
Hearing: Conversation - Frequently 
Hearing: Other Sounds - Rarely 
Interpersonal Communication - Rarely 
Kneeling - Rarely 
Lifting Lifting 50+ Lbs. - Rarely 
Lifting Pulling - Rarely 
Pushing - Rarely 
Reaching - Rarely 
Reading - Consistently 
Sitting - Consistently 
Standing - Frequently 
Stooping - Rarely 
Talking - Frequently 
Thinking/Reasoning - Consistently 
Use of Hands - Consistently 
Color Vision - Frequently 
Visual Acuity: Far - Consistently 
Visual Acuity: Near - Consistently 
Walking - Frequently

TriHealth SERVE Standards and ALWAYS Behaviors

At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following:

Serve: ALWAYS... 
• Welcome everyone by making eye contact, greeting with a smile, and saying "hello" 
• Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist 
• Refrain from using cell phones for personal reasons in public spaces or patient care areas

Excel: ALWAYS... 
• Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met 
• Offer patients and guests priority when waiting (lines, elevators) 
• Work on improving quality, safety, and service

Respect: ALWAYS... 
• Respect cultural and spiritual differences and honor individual preferences. 
• Respect everyone's opinion and contribution, regardless of title/role. 
• Speak positively about my team members and other departments in front of patients and guests.

Value: ALWAYS... 
• Value the time of others by striving to be on time, prepared and actively participating. 
• Pick up trash, ensuring the physical environment is clean and safe. 
• Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.

Engage: ALWAYS... 
• Acknowledge wins and frequently thank team members and others for contributions. 
• Show courtesy and compassion with customers, team members and the community