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General Description: Biller performs all aspect of billing complex claims for the Medicaid and State Waiver funded programs, including claim submittal and resolving denied or unpaid claims.
Responsibilities:
⢠Verifies the appropriateness of services rendered by reviewing billing and invoices, assuring expenditures are within guidelines established by the State of Colorado and federal Medicaid waivers and authorization according to service plans.
⢠Interacts with program directors, CCB, vendors, Medicaid and private pay family members.
⢠Tracks services provided and ensure that billing is process in a timely manner.
⢠Work closely with Medicaid on resolving billing issues.
⢠Ensures that billing is authorized and keep records of all billing and discrepancies.
⢠Participate in professional training and certification courses to improve knowledge.
⢠Record keeping/filing
⢠Assist with special projects as requested.
⢠Other duties as assigned and required.
Knowledge/Skills/Abilities
⢠Ability to work effectively and efficiently as a team member
⢠Communicate effectively both written and oral
⢠Ability to work independently with shifting roles, responsibilities and expectation in a changing environment.
⢠Organization and time management skill that demonstrate the ability to prioritize and perform multiple tasks under the pressure of tight deadlines.
⢠Demonstrate the ability to anticipate work needs, prioritize tasks, investigate discrepancies, effectively use professional judgment and perform follow through, with minimal direction.
⢠High level of attention to detail and accuracy to ensure successful submission of data with in established State and/or agency timelines, in order to maintain stable cash flows.
Experience:
Two years of experience in medical billing using web-based database systems.
Preferred: working knowledge in Colorado Developmental Disability Waiver programs.
Education:
Minimum: 1-2 years of medical/dental billing experience. (experience must be specifically documented and verifiable on your resume.)
Preferred: Associate's Degree
Material and Equipment Directly Used: Telephone, computers, printer, FAX machine, photocopier and scanning machines, 10-key calculator, word processing and spreadsheet software, web-based portal and electronic databases. Microsoft office suite.
Working Environmental/Physical Requirement: Office and community. Moderate physical activity required bending and reaching. Frequent sitting and standing required. Sufficient vision to view computer screen continuously while seated for long periods of time. Ability to speak and hear clearly over the telephone is a must to perform duties effectively.
