Physician Biller - Full-Time - (8a - 4:30p)

Supports, and is responsible for incorporating into job performance, the Frederick Health (FH) mission, vision, core values and customer service philosophy and adheres to the FH Compliance Program, including following all regulatory requirements and the FH Standards of Behavior.

The Physician Billing Representative is responsible for ensuring that patient charges and payments are correct on the patient account, insurance authorization has been obtained, timely submission of the account and timely follow up to achieve payment from third party payer or the patient. S/he demonstrates a high level of accuracy considering the volume and filing requirements of the various insurance payers; and recognizes the priorities of the work to be completed in order to maximize efficiency.

Example of Essential Functions

• Correct Availity Registration edits
• Run denials reports daily and correct claims or appeal where necessary
• Attach EOBs to secondary paper claims and submit for payment
• Attach referrals to claims and reprocess to carrier
• Print and send medical records with claims
• Key Medicaid claims for payment claims
• Work Vendor logs
• Patient and Insurance Correspondence
• Credit management
• Correct Registration errors
• Verify insurance eligibility and claim status
• Review exception batches for distribution
• Electronic payment and denial posting
• Posting of $0 balance remits
• Charge entry
• Reconciliation of Daily Batches
• Posting of daily payment batches
• Reconciliation of Daily office cash deposits
• Patient communication.

Required Knowledge, Skills and Abilities

• Knowledge of medical terminology, anatomy and physiology, pharmacology and disease processes
• Demonstrated competency with medical procedural coding (CPT/ICD10)
• Demonstrated competence with patient or customer information systems
• Intermediate proficiency and accuracy in the use of software programs such as MS Word, Excel, PowerPoint, ACCESS and Outlook
• Excellent communication skills, both verbal and written
• Ability to work in a fast paced environment
• Strong organizational skills and ability to prioritize and manage multiple tasks
• Ability to communicate information and ideas in speaking so others will understand
• Ability to understand written sentences and paragraphs in work related documents
• Ability to work professionally with a diverse population base
• Ability to maintain a high level of confidentiality
• Ability to create, compose and edit written materials
• Attention to details
• Ability to analyze and solve problems.

Minimum Education, Training, and Experience Required

• High School Diploma or GED required. Associate’s degree in business administration, or related field preferred.
• College courses in CPT and ICD-10 coding preferred.
• Minimum of two (2) years prior physician billing experience with demonstrated working knowledge of professional fee billing transactions and regulations, claims, insurance carriers, rejection and denial codes, error correction and re-posting and contractual adjustments.

Physical Demands

Sedentary - Light Work - Lifting up to 15 pounds on an infrequent basis (less than one lift every three minutes). While work is mostly done sitting, a certain amount of walking or standing is often necessary.

Ergonomic Risk Factors

Repetition: Repeating the same motion over and over again places stress on the muscles and tendons. The severity of risk depends on how often the action is repeated, the speed of the movement, the required force and muscles involved.

Awkward Posture: Posture is the position your body is in and its effect on the muscle groups that are involved in the physical activity. Awkward postures include repeated or prolonged reaching, twisting, bending, kneeling, squatting, working overhead with your hands or arms, or holding fixed positions.

Working Conditions

A. Bloodborne Pathogens Exposure Risk: Category C – NO exposure to blood or body fluids.

Reporting Relationship

Reports to Manager, Physician PFS

Caring for you as you care for the CommUNITY

Frederick Health offers a comprehensive and affordable benefits package. Health, Dental and Vision insurance are offered the 1st of the month after 30 days of employment to all employees hired to work at least 20 hours per week and we offer multiple plans to best meet your and your family's needs.

Life insurance, Short-Term Income Replacement and Long-Term Disability are employer paid for eligible employees. Frederick Health offers a robust Paid Time Off program for eligible employees. Our 403B retirement plan helps you save for your retirement and includes an employer match to eligible employees.

All employees have access to free financial planning sessions. We also offer an educational assistance program to support your education goals as well as an employer paid Employee Assistance Program.

Pay is based on experience, skills and education. If position is part-time, salary will be pro-rated based on scheduled hours. The pay range may also vary within the stated range based on specialty if applicable. Non-Exempt positions may have shift differential and/or Overtime paid, if applicable.

Hourly Range: $17.80 – 25.60

• Central Billing Office
• Full-time - 80 hours bi-weekly
• M-F, 8a - 4:30p