Job Description
Below are the general tasks, functions, and responsibilities associated with this position. The duties of this position are not limited to this job description and may be changed when necessary.
United Regional Health Care System
Summary of Essential Functions
- Coordinate Billing Department tasks under Direction of Billing Manager and Director to ensure daily work processes are completed
- Keep current with Medicare, Medicaid, VA, and Tricare Billing and Reimbursement regulations as well as claim filing rules on all other payers
- Works with Financial Analyst to ensure efficient and accurate formulation of Bill Codes by Payer
- Performs overview of monthly reports for Medicare, Medicaid, and Tricare aging and identifies problem areas. Notifies Billing Manager of issues.
- Capable of working multiple positions and assists for PTO and vacant positions as needed within the Billing Department.
- The duties of this position are not limited to the job description and can be changed by management when deemed necessary.
Educational Requirements
High school diploma or GED is required
Must be able to communicate effectively in English both verbally and in writing
Qualifications, Knowledge, and Skills
Minimum of 2 years of experience in Institutional / Professional Claim FilingKnowledge of Revenue codes, CPT / HCPCS, and ICD-10 codesFamiliar with NCCI and MUE editsKnowledge of Medicare and Medicaid Claim Filing and Reimbursement GuidelinesRequired to work a 40-hour week schedule, Monday through Friday, 8 : 00 a.m. to 4 : 30 p.m. however, additional hours may be required for completion of tasks or assignments.Intermediate use of Excel and WordAbility to use 10 key calculator by touch effectively, process large quantities of money, 40 to 45 w.p.m. typing for data section, data entry, and payment postingUnderstanding of basic math including debits and credits for use in posting payments, charges, and adjustments.Excellent customer service skills internal and external.Tact, diplomacy, and perception required in daily contact with public and patients making inquiries and dischargingPhysical Requirements
Ability to work under pressure and stress
Must distinguish between numbers and symbols
Requires eye-hand coordination and manual dexterity, corrected vision and hearing to normal range
Work Environment
Category III Employee has no occupational risk of exposure to blood or Other Potentially Infectious Materials (OPIM).
Essential Duties
Identifies and alerts Billing Staff, Billing Manager, and Director of Billing issues.Reviews and reports on Monthly Aging for Medicare, Medicaid & Tricare to Manager.Assigns and ensures Daily work processes are completed by Billing staff.Ensures claims are filed and payments received through reporting & claim aging reports.Works with Non-governmental payer audits to ensure accuracy and provides reporting for YTD results.Works with Revenue Integrity team to provide timely information on RA and ADR denials.Ongoing and as needed research and reporting on governmental claim issues.Ensures knowledge of changes from governmental payers by reading multiple communication pathways such as paper newsletters, e-newsletter, updates from payers on individual claims and researching internet information for each payer.Works with Manager to address staff education on any changes or new processes with an emphasis on high priority issues.Develops a working relationship with Patient Access, Medical Records, and Case Management for review of governmental claims.Reviews department productivity with Manager on a monthly basis and aids in developing ways to improve.Performs all other tasks / responsibilities as necessary.