Location: Artesia,NM, USA
Job Summary:
Performs billing, insurance follow-up, and collection responsibilities for physician practices with minimal supervision. Collaborative, intellectually and has a strong work ethic. Must be influential communication skills with an ability to efficiently communicate the finance story.
ESSENTIAL FUNCTIONS:
* Collaborate with other departments to ensure billing accuracy
* Develops and assist with billing policies as needed.
* Analyzing all billing procedures and identifying opportunities for improvement
* Familiarity with such terms such as MMC, HMO, PPO, Medicaid, Capitation and how these payers process claims
* Broad knowledge and understanding of payor rejections.
* Reconciling claims and resolving discrepancies.
* Determine final disposition of outstanding accounts.
* Ensure smooth and accurate billing operations
* Medical claims and or hospital collection experience with sound judgement
* Excellent communication and interpersonal skills.
ADDITIONAL RESPONSIBILITIES:
* Excellent knowledge of electronic billing procedures.
* Represents billing in projects for migration, integration and shared services strategies.
* Coordinates with other departments to ensure claims are billed correctly.
* Strong attention to detail & keeping updated records of accounts receivables trends.
* Responsible for training and resolution of errors and issues that may arise.
* Research and update billing demographic data to ensure prompt payment from the insurance payers.
* Ability to utilize standard billing systems & tools such as CPSI, RCM, Novitas & EMR and CMS guidelines
KNOWLEDGE/SKILL/ABILITIES:
* Billing & Follow up, admission & Prior Auth training.
* Training abilities
* Ability to manage time and task independently while maintain productivity
* Strong attention to detail which requires following standard operating procedures
AGE-RELATED COMPETENCIES: Demonstrates the basic knowledge and skills necessary to identify age-specific patient needs appropriate for this position.
Information Management: Treats all information and data within the scope of the position with appropriate confidentiality and security.
Risk Management/Quality Management/Safety: Cooperates fully in all Risk Management, Quality Management, and Safety Activities and Investigations.
MINIMUM POSITION QUALIFICATIONS:
* Education - High school diploma or equivalent.
* Minimum - 4-6 years of experience as a Biller and or Follow up specialist
* Work Experience - One year in an office setting; medical billing preferred.
* Training - at least 3 to 4 years Revenue Cycle & Admission experience
* License/Certification - none.
ENVIROMENTAL CONDITIONS: Work environment consists of daily patient contact, which may include exposure to blood, or other body fluids.