Location: Williamsburg,PA, USA
**Secy/Recp Billing Clerk**
**Full-time, Monday- Friday, Day Shift**
**AFSCME - Union**
**Posted: 8/27/2024**
**Purpose:**
Responsible for patient appointments, telephone communications, typing, and filing about patient care. Assists Faculty in teaching interns and residents how to conform to the requirements of the Health Care Financing Administration (HCFA) the American Osteopathic Association (AOA), and the Residency Review Committee (RRC). Performs day-to-day inpatient and outpatient billing and collections for the practice at AFP. Educates the physicians and staff in coding and billing procedures. Interacts with patients about financial issues.
**Responsibilities:**
+ Issues final account bills to CCC upon the direction of the Business Office Manager. Discuss claims with CCC personnel as needed. Notifies CCC of payments received at the office via computer reports.
+ Review payment listings from intermediaries and insurance companies for paid claims and also for unpaid claims that need to be resubmitted. Review payment listings for accurate payments and initiation of secondary billings.
+ Demographic & insurance data including authorization numbers must be obtained from the Invision System as needed when a faculty billing card is presented without this information.
+ Processes requests of medical records from payers relating to Worker's Compensation and Auto Accident claims (released after review with the Business Office Manager
+ Answers overhead billing pages and addresses issues presented by patients in person.
+ Enters weekly physicians' nursing home charges. Obtains admission date criteria required for patients from nursing home personnel.
+ Maintain up-to-date knowledge of ICD 9 diagnosis coding, CPT & HCPCS procedure coding, and medical terminology.
+ Works closely with the cashier's office and WFP staff to determine the status of payments on patient accounts. Adheres to instructions from the Hospital financial department
+ Prepares accounts with necessary coding and special billing requirements for covering physicians.
+ Enters daily physicians' hospital and palliative care charges (may not change physician codes without discussing with physician( within the established time frame. If missing, contact a physician for daily hospital charges. Physicians must also be contacted for missing or unclear diagnoses.
+ Review, correct & file insurance forms, and patient statements electronically or via paper.
+ Post payments from insurance companies and patients.
+ Responsible for entering charges to patient accounts, and determining financial status using UPMC guidelines. Assign charges and collect payments and/or insurance data for billing purposes.
+ Retrieves billing line voice mails in a timely fashion. Take appropriate action with each call.
+ Enters Medicare Part A billing into UB billing software. Electronically transmits claims to Veritus and retrieves all transmission reports. Verifies receipt of claims through the RTP file database.
+ Inpatient data collection for reports on provider status and location of hospital charges, reported monthly
+ Education and Formal Training Required: Must be a High School Diploma graduate with completion of the business/secretarial curriculum.
+ Must have completed a formal medical terminology course.
+ Experience Required: Must have a minimum of two years of experience in a medical finance setting and one year of experience in data entry.
+ Must have experience with computer systems including medically related programs and Microsoft Office, insurance, federally funded programs, and regulations of such.
+ Must have experience with computer systems involving ICD 9/CP/HCPCS coding, CMS 1500, UB92s, Medicare Medicaid, Blue Shield products, and managed care programs on inpatient and outpatient bases and electronic functions.
+ Must demonstrate the ability to maintain a high level of accuracy. **Licensure, Certifications, and Clearances:**
+ Act 34
**UPMC is an Equal Opportunity Employer/Disability/Veteran**