Job Type Full-time Description Fair Labor Standards Act Classification: Non-Exempt **Billing experience in optometry/eye care services needed. This position reviews accounts for assigned payers in order to reduce accounts receivables and enhance cash flow. This position is responsible for all aspects of electronic or paper claim submission. The position assumes responsibility for following proper insurance processes, timely follow-up and resolution of accounts, and provides feedback to management when internal problems resulting in nonpayment of claims are detected. Reports compliance issues from daily account review/payer information to management. Additionally, will provide a variety of services to patients from point of entry a timely, accurate, courteous and professional manner. Schedule
- Full-Time.
- Monday 10am-7pm, Tuesday-Friday 8am-5pm.
Account Review
- Reviews third party payment listings and takes appropriate action on accounts in order to avoid account aging and documents actions taken. Makes recommendations/decisions on account resolution.
- Reviews assigned aged account receivable. Determines needed account follow-up. Makes recommendations and documentation to supervisor/director regarding overall work efforts.
- Reviews and corrects billing and collection problems arising in patient care facilities requiring review of patient accounts, discovering errors, determining corrective action, and implementing correction.
Registration & Communication
- Greets and ascertains customer's needs via telephone and in office.
- Responds in an accurate, timely and complete manner to questions or directional needs.
- Accurately completes registrations and pre-registrations for patients by entering demographic, financial, employment, referring Provider and Emergency contact information into computer system.
- May request medical records and radiology exams prior to patient appointments. Obtains consent according to specified requirements.
- Provides resource materials required by JCAHO, Corporate Compliance and Individual Departments.
- Gives attention to the care and comfort of patients and their families.
- Provides training to new employees utilizing the organization's departmental policy and procedures.
- Answers and triages incoming telephone calls and accommodates requests timely according to department processes.
- Answers questions and provides information to caller within area of responsibility.
- Apply a minimum of one health literacy method when communicating with patients/clients.
Claims
- Initiate collection with all insurance carriers on electronically submitted and/or paper claims.
- Produces payment from third party payers to reduce account receivables as outlined by department.
- Performs case evaluation, for sliding fee scale applications and contract compliance.
Billing
- Applies proper application of billing procedures to the various types of insurance carriers and their regulations. Reviews billing for accuracy and completeness.
- Completes billing within timeframe outlined by department. Assists with posting mail receipts, Medicare, Medicaid, HMO and PPO payment listings against individual patient accounts.
- Applies knowledge and understanding of Medicare and Medicaid regulations and billing, particularly as it applies to prevention of sanctions under Fraud and Abuse initiatives.
Information
- Acquires additional information needed by each payer. Responds to billing and collection questions, referral and certifications from all outside sources.
- Patient contact may be needed to properly complete the requested information.
Training
- Participates in monthly training programs for staff on policies and procedures related to billing and collection, including proper coding, use of sliding fee scales, and financial screening. Will be responsible for training new team members as
- Actively participates in process improvement. Accurately documents issues for management follow up when appropriate. Answers questions, identifies resources, and provides problem-solving solutions. Keeps manager informed of new problems or developments; assists in resolution
Cash Posting
- Assists with the proper posting of all paper and electronic payment listings and batches which must be posted within 72 hours including applicable contractual adjustments in accordance to managed care contracts.
- Reconciles all cash posted amounts to the deposit amounts. Performs all posting functions according to departmental standards and meets departmental standards relative to productivity and quality.
Unidentified Payments
- Takes appropriate action to identify and resolve payments made on unidentified accounts. This action will include communication with Supervisor and filling out appropriate paperwork to reconcile these unidentified payments.
Reporting/Auditing
- Extracts Data to ensure all claims are created and followed up on timely and charges are entered correctly. Participates in required audits to support improved outcomes. Corrects errors reported by financial auditor.
Quality Compliance
- Maintains compliance with applicable policies, procedures, performance and quality standards. Identifies and communicates opportunities for improvement.
Service Excellence
- Meets expectations of preeminent service, including behavior that models: Service Excellence-Every encounter, every time, no exceptions and no excuses. Consistently demonstrates excellent communication, quality, professionalism and environment
Diversity & Inclusion
- We commit to fostering a diverse, inclusive, and equitable work environment, where all employees, whatever their gender, race, ethnicity, national origin, age, sexual orientation or identity, education, or disability, feels valued and respected.
- We take a nondiscriminatory approach and provides equal opportunity for employment and advancement in respective departments, programs, and worksites.
- We strive to respect and value diverse life experiences and heritages and ensures that all voices are valued and heard.
- We pledge to modeling diversity and inclusion and to maintaining an inclusive environment with equitable treatment for all.
Job responsibilities listed above is a summary and does not include other tasks requested by Center Manager and Revenue Cycle Manager.Who is HealthNet? HealthNet is a nonprofit 501 (c) (3) organization of community-based health centers located in Indianapolis and Bloomington, IN Since 1968, HealthNet has improved the health status of the neighborhoods it serves by making quality health services accessible to everyone. HealthNet annually provides affordable health care to more than 61,000 individuals through its network of 9 primary care health centers 5 dental clinics, 9 school-based clinics, a mobile health unit, and additional support services. HealthNet's mission is to improve lives with compassionate health care and support services, regardless of ability to pay. Requirements What you'll need:
- Currently not sponsoring for work visa.
- Requires High School Diploma or GED.
- Previous experience working in an eye care center or office in a billing role.
- Understanding of both Federally Qualified Health Centers and Commercial billing and collections.
- Certification in coding & billing preferred.
- Knowledge and understanding of Medicare/Medicaid regulations and billing requirements.
- Participate in monthly training programs for staff on policies and procedures related to billing and collection, including proper coding, use of sliding fee scales, and financial screening.
SET YOURSELF APART: Preferred Qualifications
- Experience in third party billing/collection with in-depth knowledge of specific third-party payer requirements.
- Requires working knowledge of medical terminology and basic medical coding practices (UBC; CPT4; HCPCS; ICD-9).
- Requires knowledge and proper application of remote electronic inquiry systems for Medicare; Medicaid; Blue Cross and/or all other Commercial payers.
- Requires ability to process adjustment claims to Medicaid and Medicare payers on resolution of credit balance claims.
- Bilingual in Spanish or Burmese preferred, but not required.
The skills you'll bring:
- Strong written and verbal communication skills.
- Ability to work independently, handle detail and work efficiently and accurately under pressure.
- Ability to multitask.
- Ability to handle sensitive patient data and must maintain a high degree of confidentiality.
- Excellent customer service/listening skills.
- Reliable transportation required.
Why work for HealthNet?
- Competitive Compensation
- Medical, Dental, and Vision Plan
- Short-Term & Long-Term Disability
- Health Savings Account & Difference Card Available within certain medical plans
- Flexible Spending Account
- Life Insurance, AD&D
- Group Accident, Critical Illness & Hospital Indemnity
- Domestic Partner Leave
- Wellness Programs
- 401k Match
- Paid Time Off accumulates at start of employment and available to use.
- Tuition Reimbursement
- Employee Referral program
Physical Requirements:
- Able to be involved in degrees of prolonged standing, walking, sitting, bending, squatting, and stooping; as well as abilities of repeated bending, stooping, and squatting.
- Able to lift, push, and/or pull light to moderately heavy weight up to 20-30 pounds is a necessary function of this position.
- Able to perform duties during periods of varied and/or prolonged work hours.
- Must be able to read, write, hear, and communicate effectively in the English language by both orally and written.
EQUAL EMPLOYMENT OPPORTUNITY: HealthNet is an Equal Employment Opportunity Employer and employment decisions are made without regard to race, color, sex, religion, national origin, age, disability, sexual orientation, or any other category protected by federal, state, or local law. Salary Description Pay dependent on experience, starting $19