Pre-bill Auditor and Biller II

If you are looking to make an impact on a meaningful scale, come join us as we embrace the Power of One!

We strive to be an employer of choice and establish a reputation for being a talent rich organization where Associates can grow their career caring for others. For over a century, we’ve served the health care needs of the people of Memphis and the Mid-South.

Audits front-end data elements of a more complex and non-routine level relative to billing a clean claim. Reviews demographics, insurance information, provider identification information, and charge capture documents and systems for accuracy and completeness. Communicates findings to AR Supervisor to ensure applicable staff are made aware of pre-bill audit findings. Working under minimal supervision, may adapt procedures, processes and techniques to meet the more complex requirements of the position. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.

Working at MLH means carrying the mission forward of caring for our community and impacting the lives of patients in every way through compassion, a deliberate focus on service expectations and a consistent thriving for excellence.

A Brief Overview
Audits front-end data elements of a more complex and non-routine level relative to billing a clean claim. Reviews demographics, insurance information, provider identification information, and charge capture documents and systems for accuracy and completeness. Communicates findings to AR Supervisor to ensure applicable staff are made aware of pre-bill audit findings. Working under minimal supervision, may adapt procedures, processes and techniques to meet the more complex requirements of the position. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.

What you will do

• Performs more complex and non-routine reviews and reports findings to AR Supervisor. Reviews demographics, insurance information, provider identification information, and charge capture documents and systems for accuracy and completeness.
• Reviews PM system and output EDI “scrubber” output and corrects claims. Reviews output from payer level system edits and corrects claims.
• Documents “scrubber” findings and reports to leader.
• Assists Lead and Supervisor with training/orienting and providing guidance to lower level staff members.
• Submits more complex and non-routine claims to third party and governmental payers.
• Performs other job functions as assigned or requested.

Education/Formal Training Requirements

• High School Diploma or Equivalent

Work Experience Requirements

• 1-3 years Billing, coding, or insurance verification

Knowledge, Skills and Abilities

• Strong knowledge all data elements compiled on standard billing forms/data sets.
• Knowledge of Practice Management Systems and basic computer skills.
• Detail oriented, excellent prioritization and organizational skills.

Supervision Provided by this Position

• There are no supervisory or lead responsibilities assigned to this position. However, will assist with training and orienting lower level Pre-Bill Auditor & Billers.

Physical Demands

• The physical activities of this position may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion.
• Must have good balance and coordination.
• The physical requirements of this position are: light work - exerting up to 25 lbs. of force occasionally and/or up to 10 lbs. of force frequently.
• The Associate is required to have close visual acuity to perform an activity, such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading.
• The conditions to which the Associate will be subject in this position: The Associate is not substantially exposed to adverse environmental conditions; job functions are typically performed under conditions such as those found in general office or administrative work.

Our Associates are passionate about what they do, the service they provide and the patients they serve. We value family, team and a Power of One culture that requires commitment to the highest standards of care and unity.

Education:

High School Diploma or Equivalent (Required)

Work Experience:

Billing, coding, or insurance verification

Certifications:

Boasting one of the South's largest medical centers, Memphis blends a friendly community, a thriving and growing downtown, and a low cost of living. We see each day as a new opportunity to make a difference in the lives of the people in our community.