ENTRY REQUIREMENTS High school graduate or equivalent required. Post high school education preferred. Six months medical billing experience or related clerical experience, with an understanding of Medicare, Medicaid, Health Maintenance Organization and commercial insurance plans, as well as an understanding of ICD-9 and CPT coding and medical terminology.
Effective verbal, written, and interpersonal communication skills with the ability to comfortably interact with diverse populations.
Ability to demonstrate competency with a standard desktop and Windows-based computer system, including a basic understanding of email, e-learning, intranet and computer navigation. Must have knowledge and ability to learn, access and utilize the relevant computer programs listed below within 90 days of hire:
eClinicalWorks – NextGen – Misys – Navicure Clearinghouse – PowerChart WebDenis – Microsoft office
Ability to exercise independent judgment within scope of knowledge and responsibility. GENERAL SUMMARY Responsible for various billing functions, including compiling, processing, payment batching, follow-up, customer service, billing inpatient/outpatient professional charges to third party insurance payers on both an electronic and manual basis to meet department standards for claims submission, payment posting and A/R follow-up. ORGANIZATION: This position’s primary customers are the practices of Munson Physician Network. This position reports to the Director of the Central Billing Office. SPECIFIC DUTIES Complete transmission process on electronic billing system for all current claims. Prepares and mails required hard copy claims to insurance companies, patients and other responsible parties. Retrieves/ receives payments and timely and accurately posts to the practice management system, electronically and manually. Balances all monies posted daily and prepares bank deposits Identifies incorrect insurance payments and/or system adjustments Identifies and verifies accuracy of credit balances for patients and insurance companies. Performs refund processes according to department standards. Documents all activity on accounts appropriately to ensure account maintenance is up-to-date for other staff members and insurance follow up Answers incoming billing inquiry calls from patients and insurance companies. Acts as a billing resource to the practice locations by communicating changes of billing, daily posting and balancing procedures, answering questions and attending team meetings as needed. Performs claims denial management and claims appeals Monitors accounts receivable and works through resolution to keep days in A/R within department standards. Receives and completes tasks from the practice management system. Performs other duties as assigned.
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