Job Code:
05-24-1-015

Location:
Anchorage

Salary:
DOE

Opening Date:
5/25/2024

Closing Date:
Open Until Filled

Summary:

Medical Billing Specialist supports the medical billing for Chugachmiut’s medical, dental, behavioral health, and pharmacy services by performing complex clerical billing functions and maintaining accurate financial records for optimal reimbursement for services provided.

Major Responsibilities:

• Prepares, reviews, and submits claims to clearinghouse using billing software for reimbursement. This includes processing electronic and paper claims to Medicaid, Medicare, commercial insurance, worker’s compensation, and grant-funded sources for all primary, secondary, and tertiary claims.
• Works directly with the payers, healthcare providers, patients, and billing team to ensure claims are processed and paid promptly by following medical billing guidelines and meeting proper billing standards.
• Answers all patient, insurance, and staff inquiries about assigned accounts.
• Works closely with the health administrative assistants to ensure that insurance data is correct and assists with any billing inquiries.
• Verifies insurance coverage for eligibility and benefits and obtains necessary documentation for reimbursement.
• Prepares, processes, and monitors all prior authorization for service coverage.
• Enters charges accurately and expeditiously to ensure proper records handling and fast payment responses.
• Prepares and posts payments and adjustments to accounts promptly.
• Reconciles payments and adjustments, ensuring posted batches match Remittance Advices.
• Generates adjustments and appeals.
• Research and appeal denied claims when necessary and report payment discrepancies to the manager.
• Identifies and prepares refunds timely and for review by the manager.
• Scans batches, prepare for manager’s review within the established timeframe and ensures workflow spreadsheet is maintained and updated.
• Prepares and monitors all patient statements.
• Monitors account receivables and follows up on unpaid claims within standard billing cycle timeframes.
• Works with patients to coordinate financial solutions, including developing self-pay arrangements and payment plans.
• Maintains billing records according to medical record retention laws.
• Screens patients and clients for insurance eligibility and assists individuals with completing applications for Medicare, Medicaid, and Tricare.
• Represents Chugachmiut positively and respectfully, assisting in promoting and maintaining good public relations among staff, community groups, and professional organizations.
• Conforms to safety policies and general housekeeping practices.
• Demonstrates sound work ethics and flexibility and shows dedication to the position.
• Demonstrates a positive attitude, is respectful, and possesses cultural awareness and sensitivity toward patients, co-workers, and others.
• Keeps customer service and the organization’s mission in mind when interacting with all patients, co-workers, and others.
• Prepared to start shift on time, meet attendance standards, and work the hours necessary to perform the job’s essential functions.
• Embraces, supports, and promotes the core values of respect, integrity, trust, compassion, and quality, which align with Chugachmiut’s Mission and Vision through their actions. and interactions with all patients, staff, and others.
• Conforms to Chugachmiut policies, strict employee confidentiality, HIPAA, and 42 CFR Part 2 regulations.
• Performs other duties as assigned or required.

Education Requirements:

• High school diploma or GED equivalent.
• Non-supervisory-Three (3) years’ experience in medical billing, education, and/or training may be substituted for experience.
• Two (2) years experience with electronic health system applications, Cerner, nThrive, and Eaglesoft experience preferred.
• Experience working in an Alaska Native Tribal Health billing environment is preferred.

Hours of Work:

Hours of work are 8:30 a.m. to 5:00 p.m. with an hour for lunch. This is a full-time 37.5 hours per week and 1950 hours per year position. Chugachmiut maintains a drug/alcohol free and non-smoking environment.
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Benefits: *Chugachmiut offers its employees a generous and robust benefits package. Please visit www.chugachmiut.org for a complete list of our benefits.

Job Type: Full-time

Benefits:

• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Work setting:

• Office

Work Location: In person