This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Patient Financial Services duties: Facilitates the reimbursement for clinical services provided to patients. Submits claims to health insurers, follows up with health insurers about submitted claims, and performs appeals for non-clinical denials. An organizational related support or service (administrative or clerical) role operating in a "hands on" environment. The majority of time is spent in the delivery of support services or activities, typically under supervision. An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education. Works under moderate supervision, problems are typically of a routine nature, but may at times require interpretation or deviation from standard procedures, and communicates information that requires some explanation or interpretation.
Under general supervision, this position is responsible for supporting the day-to-day operations. This position is responsible for but not limited to overseeing scanning and indexing of correspondence and to ensure proper distribution of all incoming mail, retrieving all incoming customer service voicemails, processing of invoices, and other duties as assigned.
1. High school diploma or equivalent.
2. Two (2) years of experience in an automated medical billing and collection environment for a medical services provider and/or third-party payer OR Two (2) years of experience in a hospital setting working with professional and technical charges.
Preferred Qualifications:
1. Completion of a medical terminology course to attain understanding of CPT and ICD diagnosis coding.
2. Certified Revenue Cycle Representative (CRCR) OR Certified Professional Coder (CPC).
Duties and Responsibilities: The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list. Other duties and responsibilities may be assigned.
1. Oversees scanning and indexing of all incoming correspondence to ensure all incoming billing is distributed to appropriate areas and posted accurately within Epic.
2. May check and retrieve all incoming voicemail messages for our Customer Service team and distributes to team for appropriate follow-up for patient billing concerns.
3. Ensures all invoices are current and up to date and works with Accounts Payable for resolution.
4. May work with the bank lockboxes and Onbase to identify trends or issues with the incoming correspondence to ensure the mail is appropriately indexed to reduce manual workflows.
5. May be responsible for assisting both the Customer Service and Cash Posting Supervisor on projects and tasks that will support the Patient Accounts Team as a whole.
6. Works closely with team members to increase effectiveness and efficiency of overall Departmental functions.
7. Interacts on a regular basis with other areas of Patient Financial Services as well as Revenue Cycle.
8. Assists the Customer Service supervisor with any needs and requirements between the department and Bad Debt or Early out self-pay vendors for data.
9. Consistently achieves and maintains performance standards for assigned productivity.
10. Interacts with maintenance for any office-related issues, needs, or emergencies.
11. Works closely with team members to increase effectiveness and efficiency of overall workflow and ownership of incoming mail and correspondence.
12. Knowledge and understanding of different forms of incoming mail, and ownership, knowledge of EOBs and how to interpret pieces of mail.
13. May oversee department charge review work queues, ensuring charge accuracy.
14. May review documentation to ensure that all charges are captured to maximum revenue.
15. Escalates concerns and reports any billing inconsistencies to Manager.
1. Professional office environment with typical office requirements such as computers, phones, photocopiers, filing cabinets, etc.
2. Frequently required to speak, hear, communicate and exchange information.
3. Able to see and read computer displays, read fine print, and/or normal type size print and distinguish letters, numbers and symbols.
4. Occasionally lift and/or move up to 25 pounds.
1. Excellent communication skills and the ability to effectively communicate with all areas of Patient Financial Services as well as Revenue Cycle.
2. Excellent interpersonal skills with the ability to react in a professional manner.
3. Ability to work independently and as part of a team in a fast-paced environment to satisfy the needs to support all areas of Patient Financial Services.
4. Understanding medical terminology and CPT and ICD-10 diagnosis.
5. Exceptional organization skills.
6. Time management to be able to complete tasks within a specified time.
7. Ability to develop and maintain professional, service-oriented working relationships with leadership, patients, and co-workers.
8. Ability to work independently or in a team environment.
9. Attention to detail to ensure correspondence is distributed to appropriate areas of Revenue Cycle.
10. Ability to learn PC based computer systems, word processing, database and spreadsheet software programs. Proficient in using computers and navigating through third party application systems and web portals efficiently and effectively.
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