Medical Biller

The Patient Accounts Billing Representative is responsible for review of unbilled claims and bills, assure timely billing
and claim resolution to expedite payment. Process all accounts in order to minimize billing time and maximize cash
flow. Completes the editing of claims in the HIS system. Completes the processing of claims either on paper or
electronically to third party carriers. Completes follow-up on aged accounts as directed. Review trial balance reports
and processed late charges.

Essential Functions and Responsibilities Includes the Following:
1. Understands and adheres to the WPH Performance Standards, Policies and Behaviors
2. Insure adherence to federal and state billing regulations
3. Completes accurate billing to all third-party insurance carriers
4. Monitors host system and biller scrubber to insure timely resolution of unbilled accounts
5. Completes review of third-party trial balance reports within the current month
6. Researches and initiates refunds to patients or insurance carriers as needed
7. Sends inquiries to patients regarding inaccurate or incomplete information
8. Completes charge adjustments and allowances entries on accounts as needed
9. Recodes accounts by insurance carrier and plan number and enters into the HIS for re-billing purposes
10. Processes rejections on third party accounts
11. Reviews mail correspondence and responds accordingly
12. Review on-line billing edits for errors, corrections, or missing information. Enter necessary corrections into HIS
13. Assists with telephone calls as needed
14. Completes rebilling process for late charges daily
15. Monitors host system and bill scrubber for billing delays and to expedite processing
16. Performs all other related duties as assigned

Education & Experience Requirements:
- High School Graduate required
- Clerical experience required
- Clerical and business aptitude with one to two years hospital experience
- Ability to use basic office equipment and knowledge of CTR computer terminals a plus
- Medical terminology helpful but not mandatory
- Effective 12/1/2022 the HBI (Healthcare Business Insights) one time certification course is required and must be completed during the onboarding period and prior to start date