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Company Overview 

United Surgical Partners International provides first-class services for local communities and we recognize that our employees are our number one asset. Thank you for your interest in USPI.

We are looking for caring, hard-working and enthusiastic individuals to become a part of the USPI team. We offer a variety of rewarding and challenging career opportunities with competitive salaries, great benefits and professional development opportunities.

Learn More about United Surgical Partners
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Biller & Collector    Apply Now
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Job Description 



Date Posted:  06 / 21 / 2012

Facility:  Gamma Surgery Center

Job Category:  Business Office




Position Description

Medical Biller



 

POSITION SUMMARY

Plans, organizes and directs all aspects of the billing including the development/administration of all policies for claims processing.

 

REPORTING RELATIONSHIPS:

 



  1. Reports directly to the Business Office Manager

  2. Indirectly to the Regional Vice President



 

WORKING RELATIONSHIPS:

 



  1. Collaborates with Insurance Coordinator on Insurance Authorizations, claim numbers and adjusters.

  2. Works with Pre-Admissions clerk of any cancellations and no show fees.

  3. Communicates with any and every Adjuster, Nurse case manager and Benefits organizer for negotiations on services rendered.

  4. Collaborates with Business Office Manager and the Center Director.



 

PRINCIPAL ACCOUNTABLITIES:

 

  • Maintains diagnostic master file and CPT master file in accordance with SIS guidelines.

  • Maintains (on an interim basis) the procedure code master file; evaluates and develops new entries.

  • Interprets and enforces third party payer rules and regulations; including Medicare requirements.

  • Works with physician offices to resolve coding issues.

  • Maintains knowledge of and complies with established policies and procedures.

  • Audits accounts to assure compliance with applicable laws and regulations relative to fraud and abuse issues.

  • Monitors Medicare reimbursements and maintains files.

  • Knowledge of coding policies and procedures; established in accordance with HCFA and third party payers.

  • Maintains knowledge of Medicare and third party contracts as it relates to ASC’s.

  • Ensures all billing and coding requirements are completed which relate to month-end closing.

  • Maintains a high level of proficiency in computer applications.

  • Maintains the strictest confidentiality.

  • Performs related work as required.



 

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/ or ability required.  Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

 



  1. Five years of coding experience and/or CPC preferred.

  2. Thorough understanding of the insurance industry and how it relates to Ambulatory Surgery Centers.

  3. Knowledge of governmental regulations and HCFA guidelines as it pertains to coding and compliance.

  4. Maintains a high level of proficiency in computer applications.

  5. Skills in exercising a high degree of initiative, judgment, discretion and decision-making to achieve organizational objectives.

  6. Skills in establishing and maintaining effective working relationships with patients, staff, physician offices, and the general public.

  7. Ability to communicate clearly and effectively with all levels of management



 

 

PHYSICIAL REQUIREMENTS

 

  • Must exhibit desirable trunk and extremity mobility and strength to perform job duties.

  • Must be able to lift a minimum of 35 pounds safely

  • Must be able to see, hear, and speak English.

  • Must be able to sit for long periods



 

WORKING ENVIROMENT

In the work environment of the center, there may be potential exposure to communicable diseases,

contaminated blood and body fluids, and hazardous materials. In addition fluoroscopy is utilized which may expose the employee to radiation.

 


 






 


Job Requirements 



Minimum Experience:  2

Preferred Experience:  2

Medical Collector


 

POSITION SUMMARY


The Medical Collector is responsible for follow-up and collection of claims for Private Insurance, Workers Compensation, and Contract Lien accounts. The Collector is also responsible for Payment Posting and Secondary Insurance Billing.
 

REPORTING RELATIONSHIPS:


  1. Reports directly to the Business Office Manager.

  2. Reports indirectly to the Regional Vice President.


 

WORKING RELATIONSHIPS:


  1. Works cooperatively with the Business Office Manager, Medical Biller, Lien Claimant Representative and Insurance Clerk as needed for effective collections.

  2. Works with Business Office Manager on any Contract Lien Carrier that fails to make an appropriate payment or denies a claim.

  3. Works with Lien Claimant Representative on any Work Comp claims that are beyond 75 days old.

  4. Collaborates with the Business Office Manager and the Center Director


 

PRINCIPAL ACCOUNTABLITIES:

             


  1. Completes and mails 30 and 60-day letters to Carriers as appropriate on unpaid claims

  2. Makes follow-up calls to Work Comp, Private Insurance and Contract Lien Carriers on all claims that are overdue.

  3. Sends appeal letters to Insurance Carriers that send an incomplete payment.

  4. Posts all daily deposits and bills secondary Carriers when appropriate.

  5. Sends monthly statements to patients.

  6. Sends collection letters to patients and collaborates with Business Office Manager and the Center Director.

  7. Performs other duties pertinent to the business office as requested by the Center Director.

  8. Performs related work as required.


 

QUALIFICATIONS:To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.


  1. Graduate of high school or equivalent.

  2. Ability to work with professional and nonprofessional personnel.

  3. Ability to communicate with the general public in a courteous manner.

  4. A high degree of confidentiality in maintaining records is required.

  5. Working knowledge of business office procedures and accounting principles.

  6. Minimum 2 years experience in the medical field.


 

PHYSICIAL REQUIREMENTS:
  • Must exhibit desirable trunk and extremity mobility and strength to perform job duties.

  •  Must be able to lift a minimum of 35 pounds safely

  • Must be able to see, hear, and speak English

  • Must be able to sit for long periods


 

 


WORKING ENVIRONMENT:

 

In the work environment of the center, there may be potential exposure to communicable diseases, contaminated blood and body fluids, and hazardous materials. In addition fluoroscopy is utilized which may expose the employee to radiation.

 

  
 

 

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