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The Role
Handles paper and electronic billing, collections, insurance verification, authorizations, claim edits, aging reports, denials, and claim resubmissions. Reviews and audits ICD-9, ICD-10, and CPT coding, maintains payer-related payment information, documents collection actions, responds to payer and patient inquiries, escalates issues, and assists with training new staff.
Summary Generated by Built In
Under direct supervision, the Insurance Biller is responsible for all aspects of paper and electronic billing as well as collections activities including reviewing and auditing codes and verifying insurance..Core Competencies ExperienceNumber of Years ExperienceType of Experience1One year billing or collection experience in a medical office or hospital.
- Reviews claim scrubber and resolves claim edits.
- Maintains payor-related items, such as EFTs and Payor IDs for 835s.
- Verifies insurance eligibility and authorization.
- Works monthly aging of PPO's, Medicare, HMO's, cash and Workers Compensation.
- Documents detailed notes including action items taken, when appropriate.
- Responds timely and accurately to all incoming correspondence and inquiries from payers, patients and other departments.
- Reviews reports to identify denials from Medicare, PPOs, Worker Compensation, Commercial and Contracted carriers; corrects and resubmits claims using accurate ICD-9,ICD-10 and CPT codes; suggests action plans to eliminate denials in the future.
- Elevates issues as appropriate to Supervisor.
- Assists with orientation and training of new employees/ volunteers, as assigned.
Compensation Range
$25.00 - $33.44 / Hour
Skills Required
- One year of billing or collection experience in a medical office or hospital
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The Company
What We Do
Torrance Memorial Medical Center is a nonprofit, 588-bed regional hospital serving South Bay, Peninsula, and Harbor communities. Founded in 1925, it provides integrated healthcare through a network of physicians and comprehensive services designed to support coordinated, continuous patient care. Its mission and operations focus on delivering high-quality medical services and improving the health and well-being of the communities it serves.
