Job Description: ESSENTIAL JOB FUNCTIONS Completes information on insurance forms. Completes 1500 HCFA insurance for specifications required by insurance companies to allow for timely payment. Maintains a workable knowledge regarding specifications in billing Medicare, Medicaid, Tricare and Commercial: monitoring those accounts to meet specifications. Monitors 1500 for demographic, CPT and charge accuracy. Monitors current fee schedule and recommends as necessary, in compliance with state and federal law. Assist insurance companies inquiring about accounts relative to insurance benefits deposition. Demonstrates knowledge of the personal computer and applicable keystrokes in the electronic transmission of claims, including the correction of claims with minimal interruption. Maintains a workable knowledge of the physician billing system. Follows up on unpaid claims for both insurance and patients via phone, fax or mail, knowing when to become assertive. Identifies overpayments on patient accounts and initiates refund and adjustment process in accordance with internal controls. Answer phone and assists customers promptly and courteously who age through geriatric or who are emancipated minors. Also assists physician offices promptly and courteously. IP Maintains a working knowledge of PCN, retrieving information as needed for daily work disposition. Maintains strict patient confidentiality. Performs special assignments as required. Able to demonstrate proper usage of office equipment. Researches line item EOB's for incorrect payment levels and works directly with insurance companies for assurance of benefits and correct reimbursement through oral and written communication. Monitors and maintains control for balancing purposes. Monitors appropriate codes using the ICD-10 and the CPT formats. Prints, reviews and mails all insurance claims as needed on a regular basis. Responds to and/or directs all correspondence. Maintains direct line of communication with the providers and staff. Communicates with the AR Manager regarding problem areas. Maintains knowledge of Corporate Compliance issues pertaining to daily work. Performs other duties as assigned.
EDUCATION - High school graduate or equivalent required.
EXPERIENCE - Minimum of two years of experience in a medical billing environment working with insurance and patient claims processing required.
- Productive typing ability equivalent to 30 w.p.m. required.
- Considerable skill in interpersonal communications and the ability to work well with others as a team required.
- Ability to keep accurate financial records and perform mathematical tasks required.
- Knowledge of medical terminology, ICD-10 and CPT coding required.
- Knowledge of E/M procedural coding preferred.
- Computer knowledge required.
- Knowledge of Windows preferred
PHYSICAL DEMANDS - Position has no unusual demands.
- Typical office job, requiring lifting of 10 pounds maximum, with occasional lifting and carrying of medical records.
- Position may require walking or standing, stooping, or bending.
- Minor discomfort from continual use of video display terminal.
Time Type: Full time We continually help our community and employees flourish... one life at a time. As a Seven Counties Services employee there are many benefits to enjoy. Below are just some of the great benefits you might be eligible for with Seven Counties Services.
- Health & Wellness
- Medical Coverage
- Dental Coverage
- Vision Coverage
- Flexible Spending Account
- Health Savings Account
- Short Term Disability
- Long Term Disability - Company Paid
- Financial Wellbeing
- Competitive Compensation Packages
- Life Insurance - Company Paid
- Accidental Death & Dismemberment Insurance - Company Paid
- 403b Retirement Plan with Company Funded Matching
- Retirement and Financial Planning Services
- Career Development and Growth
- Tuition Assistance Plans
- Loan Forgiveness options through federal programs (National Health Service Corps & Public Service Loan Forgiveness)
- Student Loan Repayment Assistance
- Clinical Supervision toward licensure and reimbursement for certain license applications
- At Seven Counties Services training is one of our highest priorities. We provide company paid professional training for various skills, certifications, and continuing education
- Opportunities for growth and movement - We encourage our employees to consider new growth opportunities with us
- Leadership Academy for our rising stars, supervisors, and leaders
- Seven Counties Services and Center for Clinical Excellence provide staff with industry best practices and processes
- Work Life Balance
- Paid Time Off - Generous PTO for Vacations, Illness, Personal Days, Etc. (10 Paid Holidays)
- Flexible Work Schedules to promote a Healthy Work Life Balance
- Employee Assistance Program - assists employees with personal problems and/or work-related problems that may impact their job performance, health, mental and emotional well-being