Commercial Insurance Biller

We are seeking an experienced Commercial Insurance Biller to join our team. The ideal candidate will have a strong background in medical billing and coding for Skilled nursing facilities, as well as experience working with commercial insurance companies. This position has the opportunity to become a hybrid role working from home and in office after training.

Responsibilities:

• Review and follow up with the facilities to ensure facility has received authorization to provide services to commercial insurance payers.


• Ensure all rates are correct within the billing software.


• Bill according to the outlined billing schedule as set by the Avalon Corporate Office. Prepare, review, and transmit claims using billing software through electronic and paper claim processing.


• Provide claim follow up based on Avalon claim review protocol. Contact commercial insurance providers through phone and online review of outstanding claims. Follow up process will continue until claims are reduced from outstanding Accounts Receivable (AR).


• Research and review outstanding claims until the AR payer has been relieved. Process refunds and adjustments according to Avalon guidelines.


• Collect and process the payment as indicated on the Explanation of Benefits (EOB) for patients’ dates of service. Payments which are not equal to outstanding AR will be researched and reprocessed for refunds, additional payment request, or adjustment needs.


• Work effectively with facility personal to resolve billing issues.


• Complete monthly aging for facilities and attend aging review meetings when necessary.

Qualifications:

• Must have experience billing for Skilled nursing facilities


• Associate's degree (AA) or equivalent from two-year college or technical school; or two or more years related experience and/or training; or equivalent combination of education and experience.


• Minimum 2 years of billing experience.


• Ability to adapt to a flexible work schedule.


• Ability to relate positively, effectively and appropriately with residents, families, community members, volunteers and other staff.


• Possess special interest in, and a positive attitude about, working with long-term care residents and the elderly.


• Ability to read, write, speak and understand English.


• Demonstrate basic computer knowledge and ability, including e-mail, with an aptitude to learn company applications.