GENERAL SUMMARY OF DUTIES: Responsible for working with the physicians and
office staff to ensure that all office visits, consults and surgeries are
billed in an appropriately and in a timely manner, aggressively manages AR,
Follows up on claims payments/status and assists patients to answer any billing
related questions or concerns
LOCATION: Murrieta
SUPERVISON RECEIVED: Practice Manager and Office Manager.
SUPERVISION
EXERCISED: None
Hours: Monday- Thursday 7:30am-5:00Pm and Friday:
7:30am- 1:00PM
Overtime Status: Non-exempt.
ESSENTIAL FUNCTIONS:
1.
Researches all
information needed to complete billing process, includes obtaining charge
information from physicians.
2.
Reviews Operative
notes and compares to codes provided by physician for accuracy, obtains information
about procedures performed and diagnosis information and uses coding expertise
to correct or modify codes when necessary.
3.
Electronically
submits Surgical claims and E&M claims to clearing house for processing by
insurance company
4.
Processes all
insurance provider’s correspondence, signature, and insurance forms.
5.
Assists patients
in completing payment arrangements. Skillfully answers patients’ questions and
concerns.
6.
Keys charge
information into entry program and produces billing.
7.
Conducts,
recommends, and educates on all coding of services rendered
8.
Follows-up with
insurance companies and ensures claims are correctly paid/processed per insurance
fee schedules.
9.
Resubmits
insurance claims that have received no response or are not on file.
10.
Works with other
staff to follow-up on accounts until zero balance.
11.
Assists error
resolution.
12.
Maintains
required billing records, reports, files.
13.
Identifies,
initiates, implements and manages business practices, policies, processes and
goals
14.
Proficient
organizational skills, attention to detail and accuracy
15.
Ability to
exercise initiative, problem-solving and decision making
16.
Excellent
interpersonal and communication skills.
17.
Must be a team
player
18.
Demonstrates
customer service-oriented attitude/behavior
19.
Participates in
educational activities and out of town educational conferences.
20.
Maintains
strictest confidentiality, HIPAA compliance
21.
Other duties as
assigned.
SCOPE:
A. Operates
within financial policies, procedures and budget with effective use of
resources
B. Ensures
compliance in federal, state and other regulations including corporate,
compliance, licensure, safety and security as relates to general office
operations
The job holder must
demonstrate current competencies applicable to the job position.
EDUCATION/ CERTIFICATION:
High school graduation or GED.
Certified Biller
Prefer
-Certified Professional Coder Certification through a Professional Coding
Program, such as AAPC (American Academy of Professional Coders) or AHIMA
(American Health Information Management Association)
EXPERIENCE: Billing and Coding experience- 3 years +
Neurosurgery experience preferred
KNOWLEDGE:
- Knowledge of billing
practices and clinic policies and procedures.
- Knowledge of coding and
clinic operating policies.
- Knowledge of medical
terminology.
- Knowledge of various
insurance payer’s including their policies and procedures
- Knowledge of grammar,
spelling, and punctuation to type correspondence.
- Knowledge of accounting
principles as they apply to A/R
SKILLS:
- Skill in computer
programs, spreadsheets and applications.
- Skill in using a
calculator.
- Skill in typing 40 wpm.
- Skill in A/R management
principles
ABILITIES:
- Ability to understand
and interpret policies and regulations.
- Ability to prepare
documents in response to complaints and inquiries.
- Ability to examine documents
for accuracy and completeness.
- Ability to read,
understand, and follow oral and written instruction.
- Ability to sort and file
materials correctly by alphabetical or numeric system.
- Ability to communicate
effectively and work with others.
ENVIRONMENTAL / WORKING CONDITIONS: Work is performed in an
office environment. Involves frequent contact with physicians, staff, patients
and insurance companies. Work may be stressful at times. Contact may involve
dealing with irate people.
PHYSICAL/MENTAL DEMANDS: Work may require hand
dexterity for office machine operation, stooping and bending to files and
supplies, mobility to complete errands or deliveries, or sitting for extended
periods of time. Manual dexterity for using a calculator or computer keyboard.