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Medical Biller

Job Detail

  • Job ID 43160
  • Career Level Mid Career
  • Experience 2 Years
  • Gender No preference
  • Industry Healthcare, other
  • Nationality No preference
  • Qualifications Degree Bachelor

Job Description

Department / Branch Profile:

The Finance department will contribute to realization of Sidra’s vision by providing strategic direction, stewardship and excellence of service. Finance includes the following core functional areas:

  • Financial Services
  • Reporting, Planning and Budgeting
  • Revenue Cycle Management & Treasury

Finance provides services to departments across the organization and also works with external partners at both the operational and movement level.

Job Summary:

The Medical Biller is responsible for preparing claims for submission to the National Health Insurance Company as well as other private payers. The incumbent is responsible for timely submission of claims based on agreed submission terms with the insurance providers. He/She is also responsible for following up on claims and processing resubmissions as required.

Key Role Accountabilities:

  • Releases completed claims for submission.
  • Requests additional information from clinical areas in response to claims denials or inquiries by insurance providers.
  • Prepares and processes claims based on claims work lists for submission to insurance providers or IPAs
  • Verifies claims for accuracy and completeness of information.
  • Communicates with clinical areas to resolve any claim edits issues.
  • Ensures that claim formats concur with insurance provider requirements.
  • Prepares clean claims for electronic and/or manual submission.
  • Accesses Cerner Charge Services to produce and submit claims.
  • Follows up on submitted claims to ensure timely payment processing.
  • Contacts insurance providers or TPs on as needed basis.
  • Identifies unpaid and partially paid claims and takes the necessary steps for appeal or resubmission.
  • Processes claim re-submission as required.
  • Posts insurance payments on the system.
  • Refers patient related liabilities to the AR Section for processing.
  • Escalates unresolved claims related issues to the Supervisor – Patient Billing and Revenue Reconciliation for further action.
  • Documents events and interactions using electronic and manual systems.
  • Maintains billing records in accordance with internal standards.
  • Adheres to Sidra’s standards as they appear in the Code of Conduct and Conflict of Interest policies
  • Adheres to and promotes Sidra’s Values

Work Environment the Role Operates in:

  • Work is normally performed in an office environment
  • No or very limited physical effort is required
  • No or very little exposure to physical risk

Qualifications, Experience  & Skills:

  • Education:
    1. Bachelor Degree – Commerce, Health Information, or relevant discipline
  • Experience:
    1. 2+ years’ of experience in medical billing using an electronic billing and insurance using system

Required skills