Description

Job Summary:

100% Remote Biller should have a broad knowledge of healthcare insurance billing including CPT and ICD10 codes, preparing and submitting clean claims to insurance companies, posting both patient and insurance payments, recognizing correct insurance adjustments, following up on insurance claim denials and appeals, and acquiring insurance authorizations. This position requires the ability to work independently, accomplish goals, excellent customer service and communication skills, creativity, patience, and flexibility. * All remote billers must live 100 miles outside of Artesia General Hospital.

ESSENTIAL FUNCTIONS:

To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.

The Medical Billing and Coding Specialist position needs to have a broad knowledge of healthcare insurance billing including CPT and ICD10 codes, preparing and submitting clean claims to insurance companies, posting both patient and insurance payments, recognizing correct insurance adjustments, following up on insurance claim denials and appeals, and acquiring insurance authorizations.

This position requires the ability to work independently, accomplish goals, excellent customer service and communication skills, creativity, patience, and flexibility

Works as part of a team to develop dashboards and performance tools, productivity for ongoing reporting to Revenue Cycle Director

Works closely with Medical Records for billing codes for all payers.

Research, resolve, and document patient inbound and outbound calls involving a wide range of issues utilizing multiple information systems. This includes communications with internal business centers and external customers. Assures customer agreement by summarizing and closing each call appropriately.

Investigates payment status and determines ultimate patient financial responsibility.

Collect outstanding balance, offer patient assistance with financial responsibility through various financial options.

Maintains patient confidentiality and data integrity in accordance with Health Information Portability Accountability Act (HIPAA), and company policies and procedures.

Exercises good judgment, interpret data, and remains knowledgeable in details of all related CPSI & Rycan contracts, policies and procedures.

Participates in process improvement initiatives; maintains teamwork, customer service production and quality standards to assure timely, efficient and accurate call resolution.

Minimize patient dissatisfaction with active listening, maintaining a professional tone, and acknowledging their concerns.

Competencies:

Accuracy - Ability to perform work accurately and thoroughly

Communication - Ability to communicate effectively, verbally and in writing

Computer Skills - Proficient ability to use a computer and electronic medical record.

ADDITIONAL RESPONSIBILITIES:

Perform other functions as required.

KNOWLEDGE/SKILL/ABILITIES:

• Responsible for charge and payment entry within Electronic Health Record
• Ability to prepare and submit clean claims to various insurance companies either electronically or by paper.
• Answer questions from doctors, patients, staff, and insurance companies.
• Prepare, review and send patient statements
• Responsible for correcting, completing, and processing claims for all payer codes
• Perform various collection actions including contacting patients by phone.
• Correcting and resubmitting claims to third party payers
• Basic medical terminology
• Good typing skills
• Confidentiality - Maintain patient, team member and employer confidentiality. Comply with all HIPAA regulations.
• Customer Service Oriented - Friendly, cheerful and helpful to patients and others. Ability to
• Positivity - Display a positive attitude and is a positive agent for change.
• Teamwork - Work as part of a team and collaborate with co-workers.
• Working Under Pressure - Ability to complete assigned tasks under stressful situations.

AGE-RELATED COMPETENCIES: Demonstrates the basic knowledge and skills (cognitive, technical and interpersonal) necessary to identify age-specific patient needs appropriate for all age groups.

Information Management: Treats all information and data within the scope of the position with appropriate confidentiality and security.

Risk Management/Quality Management/Safety: Cooperates fully in all Risk Management, Quality Management, and Safety Activities and Investigations.

MINIMUM POSITION QUALIFICATIONS:

Education

Associates preferred or years of experience

High School Diploma or GED

Insurance and Financial Counseling and authorization experience preferred

2 years' experience in a medical related field required

HCPC and CPT experience.

Work Experience -

Customer service experience preferred, good communication skills required, bi-lingual capabilities preferred.

ENVIROMENTAL CONDITIONS: Work environment consists of daily patient contact, which may include exposure to blood, or other body fluids.