Medical Biller II
Whitman Hospital and Medical Center, Colfax, WA, United States
Medical Biller II
Rewarding career. Competitive salary. Outstanding benefits.
Medical Biller II is responsible for managing the full life cycle of a patient account, claim creation through final resolution. This includes working closely with patients, insurance payers, and internal departments to ensure accurate billing, timely reimbursement, and a positive financial experience for patients. This role supports hospital and clinic services in a Critical Access Hospital (CAH) environment and requires an understanding of payer requirements, revenue cycle workflows, and customer service excellence. The Medical Biller II serves as a key point of contact for both patients and insurance companies, ensuring accounts are handled accurately, efficiently, and compassionately.
Standard Expectations
Promotes a Positive Working Environment
Conducts oneself in line with organization's mission, values and standards of behavior.
Accepts change and challenges with a positive attitude.
Consistently adheres to organizational policy.
Communicates Effectively
Builds relationships and works collaboratively with other staff.
Provides timely operational updates to supervisor.
Responds to communications in a timely manner.
Performs Duties Efficiently and Effectively
Follows procedures.
Acts in compliance with applicable federal, state, and local regulations.
Performs other duties as assigned.
Duties & Responsibilities
Patient Interaction and Customer Service
Serve as a point of contact for patient billing inquiries, providing clear and compassionate communication with payers, patients and clients.
Inform and assist patients with Benefit and billing questions and concerns.
Educate patients on their financial responsibility, insurance coverage, and payment options
Assist patients with payment arrangements, financial assistance, and charity care processes
Work in partnership with patients to resolve payer denials regarding Coordination of benefits, eligibility or questionnaires to ensure payer processing
Billing & Claims Submission
Prepare, review, and submit clean claims (UB-04 and/or professional) in compliance with payer requirements
Resolve claim edits, holds, and errors prior to submission
Submit corrected, replacement, and adjustment claims as needed
Coordinate timely primary, secondary, and tertiary billing processes
Accounts Receivable & Payer Follow-Up
Perform timely follow-up with insurance companies on unpaid, underpaid, or denied claims.
Analyze remittance advice (ERA/EOB) to ensure accurate payment and identify underpayments.
Research and resolve denials related to coding, medical necessity, authorizations, eligibility, etc.
Identify trends and collaborate with internal teams to prevent recurring issues
Escalate complex reimbursement issues to the Senior Manager of Billing & Reimbursement as appropriate.
Denials Management & Revenue Protection
Research and resolve hospital billing denials using Epic documentation, coding review, and clinical validation.
Identify root causes of recurring denials and collaborate with coding, clinical departments, and front-end teams to prevent reoccurrence.
Maintain clear and compliant account documentation within Epic.
Support denial trending and performance improvement initiatives.
Epic HB System Responsibilities
Utilize Epic HB work queues, dashboards, and reporting tools to manage daily billing and A/R workload.
Maintain accurate account notes, claim statuses, and follow-up actions in Epic.
Identify Epic workflow issues or system errors impacting billing and reimbursement.
Participate in Epic upgrades, testing, and optimization efforts related to hospital billing and reimbursement.
Compliance, Audit & Reimbursement Support
Ensure billing practices comply with CMS, Medicare, Medicaid, and payer regulations.
Support audits, payer reviews, and medical record requests related to hospital claims.
Assist leadership with data gathering and documentation related to cost report preparation and reimbursement analysis.
Adhere to hospital policies, HIPAA requirements, and billing compliance standards.
Team Support & Cross-Coverage
Provide cross-coverage within the Patient Financial Services or Patient Access teams as needed.
Assist with patient billing inquiries related to hospital accounts in a professional and compassionate manner.
Participate in department meetings, training, and performance improvement initiatives.
Qualifications
Required
High school diploma or GED.
Minimum of 10 years of hospital billing experience.
Strong understanding of UB-04 claims, revenue codes, and hospital billing workflows.
Strong computer skills in data entry, and knowledge of Electronic Medical Record software; Microsoft Office Suite.
Experience billing in a Critical Access Hospital.
Experience with hospital denial management and payer appeals.
Knowledge of ICD-10, CPT, and HCPC's and hospital charging concepts.
Preferred
Working knowledge of Epic HB strongly preferred.
Experience billing Medicare and Medicaid hospital claims strongly preferred.
Associate's degree in healthcare administration, business, or related field.
Completion of medical billing terminology courses.
Work Environment and Physical Demands
This position is primarily worked in an office environment. Primarily stationary with occasional standing, walking, lifting, reaching carrying, kneeling, bending, stooping, pushing and pulling of objects weighing up to 20lbs. The position requires continuous finger dexterity and fine manipulation.
The employee must demonstrate the ability to perform the essential functions of the position, with or without reasonable accommodation.
If you are looking for a rewarding career with a great team, you'll enjoy your career with us!
Position Details
Hours per week: 40
Employee Status: Regular Full Time
Shift: Day Shift (United States of America)
Pay Range: $26.00 - $45.50
Actual pay offered will vary based on years of experience.
Employee Benefits
Our benefit package includes medical, dental, vision, life insurance, and retirement options (403(b) & 457). Medical insurance coverage begins on day one and is available to both full time and part time employees. Additionally, employees receive discounts on medical services provided by Whitman Hospital and Medical Clinics. Differentials apply for evening, night, and weekend shifts. Our unique PTO plan enables employees to increase their accrual with each year of service!
Rewarding career. Competitive salary. Outstanding benefits.
Medical Biller II is responsible for managing the full life cycle of a patient account, claim creation through final resolution. This includes working closely with patients, insurance payers, and internal departments to ensure accurate billing, timely reimbursement, and a positive financial experience for patients. This role supports hospital and clinic services in a Critical Access Hospital (CAH) environment and requires an understanding of payer requirements, revenue cycle workflows, and customer service excellence. The Medical Biller II serves as a key point of contact for both patients and insurance companies, ensuring accounts are handled accurately, efficiently, and compassionately.
Standard Expectations
Promotes a Positive Working Environment
Conducts oneself in line with organization's mission, values and standards of behavior.
Accepts change and challenges with a positive attitude.
Consistently adheres to organizational policy.
Communicates Effectively
Builds relationships and works collaboratively with other staff.
Provides timely operational updates to supervisor.
Responds to communications in a timely manner.
Performs Duties Efficiently and Effectively
Follows procedures.
Acts in compliance with applicable federal, state, and local regulations.
Performs other duties as assigned.
Duties & Responsibilities
Patient Interaction and Customer Service
Serve as a point of contact for patient billing inquiries, providing clear and compassionate communication with payers, patients and clients.
Inform and assist patients with Benefit and billing questions and concerns.
Educate patients on their financial responsibility, insurance coverage, and payment options
Assist patients with payment arrangements, financial assistance, and charity care processes
Work in partnership with patients to resolve payer denials regarding Coordination of benefits, eligibility or questionnaires to ensure payer processing
Billing & Claims Submission
Prepare, review, and submit clean claims (UB-04 and/or professional) in compliance with payer requirements
Resolve claim edits, holds, and errors prior to submission
Submit corrected, replacement, and adjustment claims as needed
Coordinate timely primary, secondary, and tertiary billing processes
Accounts Receivable & Payer Follow-Up
Perform timely follow-up with insurance companies on unpaid, underpaid, or denied claims.
Analyze remittance advice (ERA/EOB) to ensure accurate payment and identify underpayments.
Research and resolve denials related to coding, medical necessity, authorizations, eligibility, etc.
Identify trends and collaborate with internal teams to prevent recurring issues
Escalate complex reimbursement issues to the Senior Manager of Billing & Reimbursement as appropriate.
Denials Management & Revenue Protection
Research and resolve hospital billing denials using Epic documentation, coding review, and clinical validation.
Identify root causes of recurring denials and collaborate with coding, clinical departments, and front-end teams to prevent reoccurrence.
Maintain clear and compliant account documentation within Epic.
Support denial trending and performance improvement initiatives.
Epic HB System Responsibilities
Utilize Epic HB work queues, dashboards, and reporting tools to manage daily billing and A/R workload.
Maintain accurate account notes, claim statuses, and follow-up actions in Epic.
Identify Epic workflow issues or system errors impacting billing and reimbursement.
Participate in Epic upgrades, testing, and optimization efforts related to hospital billing and reimbursement.
Compliance, Audit & Reimbursement Support
Ensure billing practices comply with CMS, Medicare, Medicaid, and payer regulations.
Support audits, payer reviews, and medical record requests related to hospital claims.
Assist leadership with data gathering and documentation related to cost report preparation and reimbursement analysis.
Adhere to hospital policies, HIPAA requirements, and billing compliance standards.
Team Support & Cross-Coverage
Provide cross-coverage within the Patient Financial Services or Patient Access teams as needed.
Assist with patient billing inquiries related to hospital accounts in a professional and compassionate manner.
Participate in department meetings, training, and performance improvement initiatives.
Qualifications
Required
High school diploma or GED.
Minimum of 10 years of hospital billing experience.
Strong understanding of UB-04 claims, revenue codes, and hospital billing workflows.
Strong computer skills in data entry, and knowledge of Electronic Medical Record software; Microsoft Office Suite.
Experience billing in a Critical Access Hospital.
Experience with hospital denial management and payer appeals.
Knowledge of ICD-10, CPT, and HCPC's and hospital charging concepts.
Preferred
Working knowledge of Epic HB strongly preferred.
Experience billing Medicare and Medicaid hospital claims strongly preferred.
Associate's degree in healthcare administration, business, or related field.
Completion of medical billing terminology courses.
Work Environment and Physical Demands
This position is primarily worked in an office environment. Primarily stationary with occasional standing, walking, lifting, reaching carrying, kneeling, bending, stooping, pushing and pulling of objects weighing up to 20lbs. The position requires continuous finger dexterity and fine manipulation.
The employee must demonstrate the ability to perform the essential functions of the position, with or without reasonable accommodation.
If you are looking for a rewarding career with a great team, you'll enjoy your career with us!
Position Details
Hours per week: 40
Employee Status: Regular Full Time
Shift: Day Shift (United States of America)
Pay Range: $26.00 - $45.50
Actual pay offered will vary based on years of experience.
Employee Benefits
Our benefit package includes medical, dental, vision, life insurance, and retirement options (403(b) & 457). Medical insurance coverage begins on day one and is available to both full time and part time employees. Additionally, employees receive discounts on medical services provided by Whitman Hospital and Medical Clinics. Differentials apply for evening, night, and weekend shifts. Our unique PTO plan enables employees to increase their accrual with each year of service!