Essential Duties and Responsibilities
- Review patient chart documentation to assure correct coding and accurate billing. Process/ Enter accurate data into EPICARE Prelude Professional Billing in a timely manner.
- Submit claims, Edits errors, and trouble shoots paper and/or electronically per carrier requirements in a timely manner. Clears errors per carrier receipt and re-submit. Trouble shoot correct and re-submit any claims returned by mail/electronically.
- Assist patients by answering questions regarding individual statements.
- On a daily basis, research claims unpaid status. Trouble-shoot and corrects to reduce AR balances.
- On a daily basis work the various Work Que’s (Charge Review, Claim Edit, Follow Up)
- Post payments to system associated with patients and insurance carrier’s remittance.
- Prepares and Process refund to patients and insurance carriers.
- Serve as a role model and mentor to staff, developing a positive team atmosphere within the department.
- Meet or exceed customer needs in a caring, effective and efficient manner.
- Maintain levels of quality that meet or exceed customer expectations through process improvement and a team oriented approach.
- Other duties or projects as assigned.
Job Requirements
- HS Diploma or GED. Completion of classes in medical terminology, anatomy and physiology, ICD-9 and Current Procedural Terminology (CPT) coding conventions, and disease process from an accredited program.
- At least two (2) year billing experience in private or health care organization (preferred but required); Experience with physician or ambulatory setting coding preferred.
- Computer skills: Working knowledge of Microsoft Word and Excel.
- Able to use health related Practice Management System.
Professional Communication
- Maintain confidentiality in matters relating to patient/family.
-
Interact with patients or designated caregiver with a variety of developmental and socio-cultural backgrounds.
-
Provide information to patients and families to reduce anxiety and convey an attitude of acceptance, sensitivity, and caring.