Job Description

Job Location: 2600 JOHNSTON ST - LAFAYETTE, LA 70503
Position Type: Full TimeEducation
Level: High School
Travel Percentage: NoneReports To: Revenue Cycle Manager
JOB DESCRIPTION SUMMARY
The Medicare / Commercial Biller oversees Medicare and private insurance billing operations, ensuring accuracy, compliance, and efficient collection processes.
ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES
- Ensures accurate and timely filing of Medicare and private insurance claims, ensuring reimbursement in accordance with contract provisions and regulatory requirements.
- Maintains a comprehensive understanding of Medicare and private insurance billing regulations, providing updates to the organization on relevant changes.
- Monitors aged accounts receivable for Medicare and private insurance, resubmits overdue claims, and prepares bad debt reports as needed.
- Collaborates with the Admissions team to ensure accurate processing of admission information for Medicare and private insurance claims.
- Conducts research and processes claims to ensure compliance with Medicare and private insurance guidelines.
- Electronically imports payments from all pay sources and accurately posts them to the financial system.
- Reconciles payments and ensures the system is prepared for monthly accounting closeout.
- Identifies and resolves issues related to payment processing, claim denials, and system errors.
- Updates billing rates and uploads data to the Suncoast system on a daily basis.
- Completes and submits Notice of Election forms in compliance with regulatory requirements.
- Communicates with patients, families, and pay source representatives to address and resolve claim processing issues.
- Coordinates with external facilities to facilitate patient transfers, admissions, discharges, and certification period updates.
- Assumes the responsibilities of the Revenue Cycle Manager during their absence, ensuring continuity of operations.
- Collaborates with clinical teams to compile and complete required reports.
- Manages patient pay collections for HOA and PMOA.
- Oversees month-end closing procedures and prepares reports for the Revenue Cycle Manager.
The above statements are intended to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks or special projects, other than those stated in this description, by supervisors/Leadership Team.

QualificationsPOSITION QUALIFICATIONS
- Education: High School Diploma or equivalent.
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Experience: Minimum of three (3) years in healthcare billing or collections, with expertise in Medicare regulations. Knowledge of Suncoast, Ability, and/or Waystar preferred.
- Skills: Strong time management, attention to detail, familiarity with medical terminology, and understanding of insurance codes and Medicare/private insurance requirements.