Job Details
Job Location
454 NEW HOLLAND AVE - LANCASTER, PA
Description
Our Mission, Vision, & Model of Care
At Union Community Care, our purpose is at the forefront of all that we do : we stand for whole health to help you live your fullest life.
We envision vibrant and healthy communities supported by inclusive healthcare that embraces each member's unique culture, needs, and values, and emboldens them to make healthful choices that fuel their well-being and the well-being of others.
We believe in whole health. This means we address and heal disease but equally important, we work at the causes of the causes, the social ills that must be addressed to achieve true equity.
We listen, learn, and embrace the complex lives and unique strengths of our patients, and we work hard to break down all barriers to care. This means we look through a grassroots lens. We connect with our communities because we are our communities. Each of us is a neighbor, a friend, a family member, and together, we are a trusted community health center.
Qualifications
JOB SUMMARY
This position is responsible for a variety of complex clerical and accounting functions related to medical accounts receivable (A / R), including insurance verification, insurance claim submission, along with collection, posting, and managing account payments. Duties also include following up on submitted claims and patient billing, along with investigating insurance denials.
SPECIFIC JOB DUTIES- Billing Specialist I
- Posting of daily charges and research missing slips to make sure all charges are captured
- Prepares, audits and generates clean claims
- Processes and posts insurance payments along with patient payments in an accurate and timely manner in accordance with Union Community Care's policies, procedures and performance goals.
- Coordinates with PAS to ensure accurate patient information for billing purposes
- Performs a variety of general clerical duties, including telephone reception, mail distribution, and other routine functions.
- Works all Claim Holds and Denials by investigating (calling), correcting and resubmitting claims to third party payers
- Answers questions from team members, patients and insurance companies
- Identifies and resolves patient billing questions and complaints
- Knowledge of Sliding Fee policy and rates
- Maintains patient demographic information, including insurance eligibility and benefit verification
- Ability to prepare, reviews, and sends patient statements
- Creates payment plans with patients; that follow the guidelines established by Union Community Care
- Participates in educational activities and attends staff meetings
- Maintains strict confidentiality and adheres to all HIPAA guidelines and regulations
- Performs other work-related duties as assigned
- Reconciles cash and batches daily
- Works on appeals to insurance companies as needed
SPECIFIC JOB DUTIES- Billing Specialist II
Preform all job duties of Billing Specialist IDemonstrates the ability to act as a coach to peersProficient in both Medical and Dental BillingSPECIFIC JOB DUTIES- Billing Team Lead
Performs all duties of Billing Specialist IWorks with Billing Specialists to research appropriate billing & coding proceduresWorks with Director of Billing to maximize revenue potential based on our unique services and providersWorks with Director of Billing to maximize department efficiencyAssists with reconciliation errorsWorks with Accounting to identify any discrepancies in cashKeeps ongoing knowledge of current CPT / CDT guidelines and educates Billing SpecialistsResponsible for Training of Billing StaffAssists with Training of PASCertification in Medical Billing or Coding preferredJOB REQUIREMENTS
To perform this job successfully, an individual must be able to perform all duties satisfactorily. The requirements listed below are representative of knowledge, skill, and / or ability required.
Knowledge of medical terminology and current CPT AND / OR CDT coding practices preferredWorking knowledge of Microsoft Office, EMR software's and other online programs; along with general business equipmentBasic mathematic skillsSpanish proficiency preferredAbility to work well with othersESSENTIAL FUNCTIONS
To fulfill the requirements of this position, all duties above are considered essential functions of the job.
ORGANIZATIONAL INVOLVEMENT
This position is required to participate in mandatory all staff meetings, team meetings and trainings.