Medical Bill Processor

PRIMARY PURPOSE: To code provider bills; to enter pre-coded billing data into the system; and to verify the output.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Keys pre-coded billing data into the system.
• Identifies and forwards complex bills to claims examiners.
• Codes provider bills in accordance with claims management system notes and state guidelines.
• Follows workers compensation/auto guidelines to evaluate the services.
• Compares qualifications of service provider with service provided.
• Involved in system maintenance/file maintenance and interface with IT department.
• Assists in account batching and distribution of incoming and outgoing mail.
• Answers customer service calls from providers, clients and claims examiners.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.
• Supports the organization's quality program(s).

QUALIFICATIONS

Education & Licensing

High School diploma or GED required.

Experience

One (1) year of general office experience or equivalent combination of education and experience required. Knowledge of medical terminology preferred.

Skills & Knowledge

• Excellent oral and written communication
• PC literate, including Microsoft Office products
• Analytical and interpretive skills
• Strong organizational skills
• Good interpersonal skills
• Ability to work in a team environment
• Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical: Computer keyboarding, travel as required

Auditory/Visual: Hearing, vision and talking

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.