Department: Billing                                Postualte
Reports To: Billing Manager
FLSA Status: Non-Exempt
Revision Date: August 2016

Position Summary

This position is primarily responsible for entering all physician and facility charges, entering appropriate billing claim codes and ensuring claims are billed accurately and efficiently. The individual will need to complete position responsibilities by following established guidelines and protocols within the appropriate time frame, and must be flexible with his/her work schedule. This position involves discretion and independent action within prescribed limits.

 

Essential Duties & Responsibilities

• Validate both facility and physician claim for all billable patients in system.
• Validate all pertinent billing information on all UB and HCFA claims.
• Cross reference Physician Name and Dates of Service with the Financial Log for accuracy on all UB and HCFA claims
• Cross reference all CPT, HCPCS and Diagnosis codes with the coding sheet for accuracy on all UB and HCFA claims.
• Ensure all patient demographics and payer information (address and/or payer ID info) are accurate for claims submission.
• Verify Insurance and make patient calls as needed
• Submit all UB and HCFA claims to clearing house.
• Run Daily Claims Report daily to ensure everything was billed.
• Bill Secondary claims with Primary EOB.
• Process Front End Rejections Daily.
• Work Corrected Claims as needed.
• Document Accounts as needed.
• Identify and Report trends as needed.
• Promote patient loyalty and retention through quality Customer Service and quick resolutions.
• Ensure delivery of excellent customer service through communication, and coordinating with other departments to resolve issues.
• Complies with all applicable policies and procedures to meet JCAHO and company standards.
• Perform other duties as assigned

Safety/Infection Control

• Demonstrate knowledge of and adhere to regulations and Emergency Center policies and procedures pertaining to safety, emergency preparedness, infection control, OSHA, fire safety and hazardous materials
Performance Improvement
• Participate in performance improvement activities as necessary

Customer Service

• Maintain confidentiality of patient related issues and adhering to all HIPAA rules and regulations.
• Demonstrate effective interpersonal skills
• Treat all patients, visitors, and staff members fairly and with respect
• Utilize effective communication methods and skills
• Explain all procedures, treatments, and care while remaining aware of language barriers
• Able to perform care in non-judgmental manner and recognize discrepancies between patient and personal beliefs.

Emergency Center Policy

• Ensure personal appearance is business casual and professional at all times
• Responsible for wearing Emergency Center identification badge at all times which must be visible and above the waistline
• Attend all required meetings and in-service education
• Remain flexible in staffing patterns and resolution of staffing conflicts; participates in temporary assignments
• Compliance with attendance standards
• Demonstrate flexibility when changes in assignments are necessary

Qualifications

EDUCATION & EXPERIENCE
• High School Diploma or Equivalent
• Minimum 2 years experience in medical billing or medical field. UB experience preferred but not required
• Experience using an electronic medical record is preferred
• Knowledge of billing guidelines
• Knowledge of coding guidelines, anatomy and physiology, biology and microbiology, pharmacology, medical terminology and abbreviations
• Verbal and written communication, organizational, typing (35-45 wpm) and data entry skills
LANGUAGE/MATH/REASONING ABILITY
• Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization
• Ability to add and subtract two digit numbers and to multiply and divide with 10’s and 100’s. Ability to perform these operations using units of American money and weight measurement, volume, and distance
• Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
COMPUTER SKILLS
• Basic computer skills
CERTIFICATE/LICENSES
• None

Competencies

• Professional Maturity: The ability to separate emotional feelings from the real issues at hand
• Responsibility: The ability to accept choices you have made and the results they have led to
• Communication: The ability to write and speak effectively; actively listens to others, and give feedback
• Flexibility: Demonstrate responsiveness and adaptability following change initiatives
• Intelligence: Understand information and apply new knowledge
• Energetic: Exhibits high levels of energy and enthusiasm
• Organized: Efficient in structuring tasks to be accomplished
• Computer Savvy: The ability to use technology efficiently and effectively

Postulate

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