Medical Biller

Job Description:

‎At Vera Whole Health, we’re seeking a Medical Biller to work as a team member on our Operations team in a remote environment. As our Medical Biller, you’ll be a vital part of a billing and claims workflow that should be seamless to our patients, but effective in ensuring claims and billing are completed with accuracy and efficiency to optimize Vera’s revenue generation. Vera’s vision for the position is that we have someone who understands medical billing, coding and isn’t afraid to dig in, driven to find answers to resolve billing/claims, and up to the challenge of working at a young, dynamic company seeking process improvement at every level.

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How will you make an impact & Requirements

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Medical Biller

About Vera 
The vision of Vera Whole Health is to create a health revolution by enlivening people, invigorating companies, and transforming healthcare. Vera Whole Health ensures that the right people get the right care at the right time, which means patients are healthier, happier and more productive. Vera Whole Health is a market leading healthcare company that provides primary care, population health management, and behavior coaching to employees via employer-funded on- or near-site clinics. By addressing the needs of both the individual and the organization, Vera dramatically improves employee health and significantly reduces costs. Come join our health revolution. 

Position Qualifications/Essential Functions: 
● Work as a Billing Subject Matter Expert to support Revenue Cycle Activities, Partners and other departments. Ensuring alignment to the Vera Whole Health model is demonstrated across the board. 
● Assist with Policy and Procedure design and implementation 
● Review negative AR trends or inefficient processes and work with leadership, training and partner teams to assess and address root cause 
● Assist with EFT enrollment 
● Support insurance and patient calls regarding payment, billing questions and account corrections

● Ensures clean claims are sent to insurance carriers in a timely manner, processing claims from the Practice Management system. This process includes working edits generated by the claim scrubbing software in NextGen, and ensuring claims are processed accurately in Clearinghouse.

● Monitors claims for missing or incorrect information 
● Ensures responses from insurance carriers for services provided are resolved in a timely manner to optimize Vera Whole Health’s revenue generation and cash flow, including posting of denials, working rejected claims and posting zero pay remits. 
● Secure needed medical documentation required or requested by insurance
● Completes the processing of inappropriately paid accounts by contacting payers, processing payer correspondence, rebilling, working denials and conducting appeals to obtain the highest possible reimbursement 
● Process and post insurance and patient payments, ensuring accuracy for account reconciliation, including resolution of payment conflicts 
● Work credit balance reports to identify insurance and patient overpayments, resulting in refunds. 
● Aged A/R account reconciliation includes investigation into account balances that have not been processed or paid by insurance companies 
● Works directly with Regional Area Manager, Clinic Managers and Finance to ensure patient concerns regarding billing are resolved to patient satisfaction 
● Special Projects as assigned 

Education/Experience: 
● High school diploma or GED 
● 3-5 years of experience in medical billing with a strong familiarity and proficiency with Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-10) Tenth Edition codes. 
● Experience with Athena and/or Next Gen billing EMR systems preferred 
● Knowledge of Commercial, Medicare, Medicare Advantage and Workers Comp insurance plans

● 3+ years’ experience with billing/collection practices and workflows 
● Experience with EMR chart and code review required 
● Demonstrated knowledge of medical terminology 
● 3-5 years’ experience with MS Office 2010 or higher 

Additional Qualifications Preferred: 
● Biller/Coder certification preferred 

Demonstrated Attributes: 
● Demonstrate an understanding of and commitment to The Vera Way by practicing its key components of mindfulness, continuous learning, a coach approach, innovation, adaptability and resilience with all members of Vera's staff, clients and patients. 
● Highly organized 
● Team player with strong interpersonal skills and ability to build effective working relationships throughout all levels of the organization - Excellent verbal and written communication ● Solution-focused 
● Ability to be creative and innovative in a fast paced environment with a lot of ambiguity and constant change 
● Ability to champion quality throughout the organization 
Physical Demands: 
● Requires looking at computer monitor/screen for extended periods of time 
● Requires repetitive motion and use of hands for computer keyboard and mouse ● Requires sitting for extended periods of time 
● Requires corrected vision, hearing and speech within normal ranges 

Compensation:  $20-$25/hr.

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About Us

apree health is leading the critical shift to value-based care across the United States. apree health brings together a best-in-class engagement platform with an advanced primary care model to provide a vastly better health and care experience, improve outcomes, and significantly lower the total cost of care for a population. At apree health, our mission is to solve the affordability crisis and empower people to make the best choices for their health and care. We offer a health benefits platform that engages employees to make better healthcare decisions and can guide them to the right program, care, and provider. Our platform also enables benefit leaders to communicate and measure their programs while driving employee engagement with targeted, relevant communications.

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Mosaic Health: Who we are

Mosaic Health is a national care delivery platform focused on expanding access to comprehensive primary care for consumers with coverage across Commercial, Individual Exchange, Medicare, and Medicaid health plans. The Business Units which comprise Mosaic Health are multi-payer and serve nearly one million consumers across 19 states, providing them with access to high quality primary care, integrated care teams, personalized navigation, expanded digital access, and specialized services for higher-need populations. Through Mosaic Health, health plans and employers have an even stronger care provider partner that delivers affordability and superior experiences for their members and employees, including value-based primary care capacity integrated with digital patient engagement and navigation. Each of the companies within Mosaic Health provide unique offerings that together promise to improve individuals' health and wellbeing, while helping care providers deliver higher quality care. For more information, please visit www.mosaichealth.com or follow Mosaic Health on LinkedIn.

Mosaic Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. 

If you require an accommodation for the application or interview process, please let us know and we will work with you to meet your needs. Please contact recruiting@apree.health for assistance.