Location: Columbia,SC, USA
Company Overview: Eau Claire Cooperative Health Center, Inc. (dba Cooperative Health) is a leading community health center serving the Midlands of South Carolina since 1981. It is deeply rooted in its mission of providing accessible, high quality, compassion health care in the spirit of the Good Samaritan. The organization's values of: treating each other with respect, putting people first, being excellent at what we do, promoting a collaborative work environment, improving community/population health, fostering innovative thinkers, and getting results, are core attributes of every employee at Cooperative Health.
Position Summary: The Revenue Cycle Specialist-Biller 1 is responsible for tracking, collecting, posting and managing claims from the time of claim submission to payment. Maintenance of all billing related documentation to insure accurate and timely billing in strict compliance with Medicare, Medicaid, commercial insurance and private pay reimbursement sources. Responsible for follow up on all accounts receivable balances.
Principles Responsibilities:
* Prepares and submits clean claims to various insurance company's either electronically or by paper.
* Answers questions from patients, internal staff and insurance companies.
* Contacts insurance companies regarding problem or unpaid claims.
* Ongoing review of aging reports to determine reason for unpaid claims.
* Identifies and resolves patient billing inquiries.
* Prepares, reviews, and sends patient balance letters.
* Tracks and reports status of delinquent claims.
* Ensures that all charges are processed within acceptable time period by insurance payer.
* Performs various collection actions including contacting insurances and patients by phone.
* Documents and follows up on claims, client requests and issues.
* Corrects and resubmits claims to payers.
* Tracks and manages claim denials from insurance companies.
* Processes payments from insurance companies and prepares a daily deposit.
* Participates in educational activities and attends monthly staff meetings.
* Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
* Maintains knowledge of all new features, functions, issues, and upgrades of Athena.
* Perform other duties as assigned.
Competencies:
* Ability to embody the mission and vision of Cooperative Health.
* Excellent written and verbal communication and problem solving skills.
* Ability to communicate with people from a variety of socioeconomic and cultural backgrounds.
* Ability to prioritize, organize and carry out work assignments independently and efficiently.
* Ability to maintain appropriate degree of confidentiality.
* Other duties as assigned.
Education & Experience:
* 3+ years of previous medical collections experience in Adult, Family Practice and/or Pediatrics with general insurance billing practice knowledge, required.
* Must have 3-4 years of experience in CPT & ICD-9/10 Coding.
* Billing related background in physician clinic setting preferred with experience in managing accounts receivable. Athena experience preferred.
* Minimum Associate degree. Additional appropriate education may be substituted for one year of billing experience.
* Individuals who are bilingual are encouraged to apply
Physical Demands
* Prolonged periods sitting or standing
* Must be able to lift up to 25 pounds
* Be able to sit, stand, stoop, squat for extended periods of time throughout the day
* Standing or walking for extended periods throughout the day
Company Conformance Statement
In the performance of respective job assignments, all employees are required to conform with Cooperative Health's:
* Board approved policies and procedures;
* Confidentiality and professional provisions;
* Compliance program; and
* Standards of conduct.
Supervisory responsibility
No