JOB FUNCTIONS AND STANDARDS:
of ICD10 requirements, CPT coding, Medicare, Medicaid, commercial carriers and
general healthcare billing guidelines is preferred.
encounter by approving claims and submitting CMS-1500, UB or Patient Statement
forms within the designated time frame.
fee discounts, collection and patient billing policies.
records conversations with patients or insurance companies in the patient’s notes.
Reviews and acts
on Explanation of Benefit (EOB) and Remittance Advice (RA’s) to ensure clean
claims. Denials will be corrected and resubmitted (when applicable) within 30
Posts payments in
a timely manner into A/R and generates reports as needed.
in RPMS training as available by staff and I.H.S. May require self study as
Regularly reports to billing
supervisor any trends, changes or unusual activity as it relates to billing of
Participate in any set
up and implementation changes in computerized billing and collections systems
10. Performs clerical work including
filing, documenting purging, faxing and general office functions.
11. Assist with in processing insurance credentialing
applications for medical, dental and behavioral health staff.
12. As backup will assist in completing application
process to sign providers up as preferred providers or eligible providers for
various federal and private insurances.
13. As backup will assist in maintaining credentialing
data base for medical, dental and behavioral health staff.
14. As backup will assist in maintaining and reconciling
daily payments. (batching and running totals)
15. Professional conduct, ethics, and confidentiality are
expected at all times.
Other Duties (specific to each individual employee’s
be asked to summarize, project or prepare statistical or other report
information for presentation.
be asked to provide review of options for possible implementation
3. All other duties and responsibilities deemed as needed