Location: Rochester,NY, USA
POSITION SUMMARY:
Under minimal direction and considerable latitude for independent judgment, performs charge entry functions for rendered services from an inpatient or outpatient setting. Responsible for an effective claim submission process to obtain maximum revenue collection.
**SUPERVISION AND DIRECTION RECEIVED:**
Receives minimal direction from physician, mid-level providers, department head and/or administrative officer. Is responsible for independently planning, executing and evaluating own work.
**SUPERVISION AND DIRECTION EXERCISED:**
May train and coordinate activities of peers or support staff.
**MACHINES AND EQUIPMENT USED:**
Standard office equipment including computer, calculator, telephone, facsimile. Will use software for electronic medical record (EMR) system, billing and appointment scheduling system, and Operating Room scheduling system and other systems as needed.
**TYPICAL DUTIES:**
1. Creates batches from reports of closed encounter forms, inpatient charge sheets, etc. obtained from the electronic medical record (EMR). Verifies the accuracy and completeness of all information such as demographics, insurance company, diagnosis, modifiers, etc. Determines correct method of resolving discrepancies by utilizing internal and external resources. Collects missing data and corrects registration errors accordingly.
2. Independently reviews and researches multiple places within the EMR for each encounter or procedure to ensure that all opportunities for billing can be utilized. Examines notes in the medical record in order to abstract medical information relevant to patient encounter to determine appropriateness of potential charge submissions.
3. Enters charges timely and accurately in the applicable billing system based on type of service and location. Correctly identifies diagnosis codes and charges are appropriate for claims to be effectively released and submitted to the assigned insurance carrier(s).
4. Troubleshoots any problems within billing system that prevents claims from being released for acceptance by insurance carrier(s). Identifies cause of edit and independently resolves issue by reviewing the patient encounter to understand the nature of the problem. Researches information within the EMR using knowledge of insurer requirements to determine solution.
5. Collaborates with office staff assigned to collections activity on unpaid, underpaid or denied claims following processing by insurance carrier(s). Gathers relevant detail from patient encounter and provides input for resolution and collection of revenue.
6. Balances batches entered to a deposit ticket prepared and balanced at the point of rendered service site for daily front end collections. Ensures monies received at time of service are properly recorded and balanced. Makes appropriate contact when discrepancies are discovered and facilitates resolution through follow up activities.
7. Acts as point of contact for patient billing questions at provider sites, answers procedural/process questions by office staff, and researches complicated accounts and patient complaints for resolution.
**QUALIFICATIONS:**
Associate's degree in Business Administration and 2 years of hospital patient accounting or consumer collections experience, or certification obtained from a nationally accredited billing program (i.e., Certified Medical Billing Specialist CMBS, Certified Medical Records Technician CMRT, Certified Medical Reimbursement Specialist CMRS); or an equivalent combination of education and experience. Ability to type 25 wpm.
The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University's mission to Learn, Discover, Heal, Create - and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations.
**How To Apply**
All applicants must apply online.
_EOE Minorities/Females/Protected Veterans/Disabled_
**Pay Range**
Pay Range: $18.65 - $26.11 Hourly
_The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations._
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**Location:** Strong Memorial Hospital
**Full/Part Time:** Full-Time
**Opening:**