Req #: 0000211555
Category: Miscellaneous
Status: Full-Time
Shift: Day
Department: UPA-DCMC Neurosurgery
Pay Range: $17.93 - $25.32 per hour

QUALIFICATIONS:

Required:

• High School Diploma or Equivalent
• Proficiency in ICD-9 Coding
• Must have a basic understanding of Medicare coding and billing requirements
• Knowledge of federal, state and third-party payer documentation requirements

Preferred:

• Associates or Bachelors degree in Healthcare Administration or related field
• 1 year billing or claims adjudication experience

SCHEDULING REQUIREMENTS:

• Working Shift: Monday – Friday
• Day Shift
• Full-Time, 35 Hours Per Week

ESSENTIAL FUNCTIONS:

• Serves are primary practice representative between the physician practice and medical billing and Patient collections vendor,
• Meets with Reimbursement and Patient Collections vendor monthly to discuss key issues, overall accounts receivable performance, and opportunities for improvement
• Provides training to administrative staff regarding new regulations/insurance industry changes
• Act as resource to billing staff and physicians
• Completes charge submission reconciliation
• Responsible for all billing corrections and fee negotiations
• Maintains knowledge of the operational details of all key positions in the business office these include insurance claim processing, payment posting, insurance claim follow up, and patient collections
• Meets with physician in charge of reimbursement to discuss difficult claims
• Meets with Manager monthly to analyze accounts receivable reports, days in receivable, and collection statistics by payor; prepares or presents data to physicians when asked
• Performs quarterly billing audits to ensure timely and accurate processing of charge and payment posting within the practice site
• Conducts detailed review of Explanation of Benefits forms from commercial and managed care payors at least quarterly; prepares or presents results to physicians
• Initiates modifications of all procedural paperwork related to accounts receivable encounter forms, billing screens, etc,
• Verification of insurance
• Authorization for surgical procedures
• Attends reimbursement and carrier seminars
• Actively participates on the Compliance Team, or prepares information for the Compliance Officer
• Maintains patient confidentiality; complies with HIPAA and compliance guidelines established by the practice
• Attends all meetings as requested

OTHER DUTIES:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.