RHC Billing/Coding Specialist at Cleveland Area Hospital

Cleveland, Oklahoma, United States -

Full Time

Start Date

Immediate

Expiry Date

31 May, 26

Salary

0.0

Posted On

03 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Billing Software, Electronic Claim Processing, Paper Claim Processing, AR Follow-up, Financial Counseling, ICD-CM-10 Coding, CPT Coding, HCPCS Coding, HIPAA Compliance, MS Excel, VLOOKUP, Pivot Tables, Customer Service, Communication Skills, Insurance Knowledge, Denial Appeals

Industry

Hospitals and Health Care

Description

Description POSITION SUMMARY: Under the direction of the Revenue Manager for Lake Area Medical Associates, this position will be responsible for ensuring quality, productivity, and an even flow of work daily. The RHC Billing Specialist will have quick typing skills, an analytical mind, exceptional attention to detail, and a passion for precision. PRINCIPAL JOB DUTIES AND RESPONSIBILITIES: Knowledge of insurance, including HMO/PPO, Medicare, Medicaid, Managed Medicare rules and guidelines. Interpreting EOBs for verifying the accuracy of insurance payer payments, adjustments, and denials. Initiating appeals for denied claims. Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing. Checking each insurance payment for accuracy and compliance with the contract discount. Responsible for the timely and accurate posting of all payments and other postings. Performs AR Follow-up. Makes collection phone calls. Answers patient billing questions. Performs Financial Counseling as needed. Performs reports as needed. Reviews accounts for outsourced collections. Answers Patient Portal billing questions. Assist with DNFB and Aging for RHC and Hospital as requested. Performs Insurance Credentialing for Hospital and RHC. Assigns the appropriate ICD-CM-10 code. Assigns appropriate Modifiers, CPT, and HCPCS. Adheres to AHIMA Ethical coding guidelines. Adheres to CPT and HCPC coding guidelines. Excellent customer service. Adhere to all policies of the organization, including (but not limited to) job description, certification/licensure requirements, mission statement, HIPAA, confidentiality standards, and patients’ rights. Demonstrates professionalism and accountability Demonstrates a caring attitude consistent with Cleveland Area Hospital toward patients, family members, employees, and other facility guests Demonstrates excellent communication skills Identifies and utilizes appropriate channels of communication. Adheres to the organization’s Mission, Vision, and Values Participates in departmental activities, meetings, and in-services, and follows established guidelines EQUIPMENT: Computer and Printer Copy Machine Fax Machine Telephone Requirements EDUCATIONAL/SKILLS REQUIRED: High school graduate or equivalent Skilled in MS Excel (VLOOKUP, formulas, Pivot tables), MS Word. Excellent mathematical skills. Excellent attention to detail. Excellent communication skills, including letters, memos, and emails. Excellent customer service and telephone skills. EXPERIENCE: 2-3 years of Rural Health Clinic billing experience Preferred experience in cash posting. Preferred experience in Athena and Cerner hospital software. RESPONSIBILITY FOR CONFIDENTIAL INFORMATION: This position may have access to patient confidential records and must comply with HIPAA regulations and Compliance Policies. WORKING CONDITIONS – PHYSICAL DEMANDS: The following physical/mental demands are required for the cash poster specialist. This position requires the following physical demands Occasional = 33% Frequent = 66% Continuous = 100% Occasionally, they must be able to be on their feet walking, standing, transporting, and/or positioning patients. Occasional lift and transfer a minimum of 25 pounds and apply a minimum of ____pounds of push/pull force while using good body mechanics. Frequently use hands to finger, handle, or feel. Frequently reach with hands and arms. Occasionally requires bending and stretching while using good body mechanics. May be exposed to communicable diseases. The above statements reflect the general details considered necessary to describe the principal function of the job as identified, and shall not be considered as a detailed description of all work requirements that may be inherent to this position. EEO STATEMENT: Cleveland Area Hospital/Lake Area Medical Associates is an equal opportunity employer and considers all qualified applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and all other protected classes.

Responsibilities

This role is responsible for ensuring quality, productivity, and workflow for RHC billing, which includes verifying insurance payments, initiating appeals for denied claims, and preparing/transmitting claims using billing software. Duties also involve accurate posting of payments, performing AR follow-up, answering patient billing questions, and assigning appropriate ICD-CM-10, CPT, and HCPCS codes.