What are the responsibilities and job description for the RHC Billing Specialist (M-F 8AM-5PM) position at Cleveland Area Hospital Holdings Inc?
Job Description
Job Description
Description :
- Are you passionate about patient care?
- Would you enjoy being an integral part of a team on the verge of new hospital construction?
- Are you motivated by ongoing improvement and an opportunity to make a measurable impact on rural healthcare in Oklahoma?
CLEVELAND AREA HOSPITAL is an independent, self-managed Critical Access Hospital half an hour west of Tulsa, Oklahoma. As the only hospital in Pawnee County, we are constantly striving to provide the highest level of care by continuously growing and updating our services and equipment. Our facilities include a level IV Trauma Center / ER, Skilled Nursing / Swing Bed program, Respiratory Therapy, C.T., 3D Mammography, a fully equipped Outpatient Rehabilitation Center, 24 / 7 Lab, and a Primary Care Clinic. The organization is a Regional Healthcare Provider in its 10th year of consistent leadership. Continuing the spirit of growth, healing, and service-driven healthcare established when the hospital first opened in 1963, Cleveland Area Hospital is on track to build a new facility, expand our services, and better serve our patients and communities.
Our campus is also home to Lake Area Medical Associates, our very own primary care clinic featuring 6 full-time providers and extended hours : 7am - 7pm, Monday - Friday. Lake Area Medical Associates’ services include wellness exams, immunizations, diagnostic lab testing, geriatric health assessments, physicals, preoperative evaluations, skin biopsies and treatment, smoking cessation, women's health services, veteran's health services, and much more.
BENEFITS :
Birthday, Anniversary and New Hire Gifts
POSITION SUMMARY : Under the direction of the RHC Billing Manager, the RHC Billing Specialist will be responsible for ensuring quality, productivity, and an even-flow of work daily. The RHC Billing Specialist will have quick typing skills, an analytical mind, exceptional attention to detail and a passion for precision.
PRINCIPAL JOB DUTIES AND RESPONSIBILITIES :
1. Adheres to all Organization policies and procedures.
2. Knowledge of insurance including HMO / PPO, Medicare, Medicaid, Managed Medicare, Managed Medicaid rules and guidelines.
3. Interpreting EOBs for verifying accuracy of insurance payer payments, adjustments and denials.
4. Accurately follows coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies.
5. Assigns appropriate ICD-10 codes.
6. Assigns appropriate Modifiers, CPT and HCPCS.
7. Initiating appeals for denied claims.
8. Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
9. Checking each insurance payment for accuracy and compliance with contract discount.
10. Work DNFB and Aging reports for RHC.
11. Responsible for timely and accurate posting of all payments, and other posting.
12. Performs AR Follow-up.
13. Reviews accounts for outsourced collections.
14. Makes collections phone calls.
15. Assists patients with setting up payment plans.
16. Performs reports as needed.
17. Adheres to AHIMA Ethical coding guidelines.
18. Adheres to CPT and HCPC coding guidelines.
19. Answer patient and patient portal billing questions.
20. Demonstrates professionalism and accountability.
21. Demonstrates a caring attitude consistent with Cleveland Area Hospital toward patients, family members, employees and other facility guests.
22. Demonstrations excellent communication skills.
23. Performs other related duties which may be inclusive but not listed in the job description.
RESPONSIBILITY FOR CONFIDENTIAL INFORMATION :
This position could have access to patient confidential records and must comply with HIPAA regulations as well as Compliance Policies.
Requirements :
EMPLOYMENT STANDARDS, EDUCATION AND STANDARDS
High School diploma or GED required. Associate’s degree preferred. Excellent interpersonal skills. Knowledge of medical records, EHR preferred. Knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes.
Must have good math skills and effective communication skills. Performing billing work requiring independent judgment with speed and accuracy. Communicating clearly and concisely, orally and in writing. Confidentiality. Ability to use the computer. Ability to work independently and to accomplish assigned work in a timely manner.
Ability to communicate with staff and the public, both in person and over the phone, in a tactful manner and under difficult situations. Understanding and carrying out verbal and written directions. Work independently in the absence of supervision. Working knowledge of all equipment, basic computer skills and demonstrate skill in employee relations and problem solving. Able to interact with wide variety of individuals and handle multiple complex situations simultaneously. Evidence of leadership, integrity, and initiative.
WORKING CONDITIONS :
Requires prolonged sitting or standing. Requires ability to distinguish letters, numbers and symbols. Requires awareness of personal limitations and flexibility. Some emotional stress resulting from diversity and intensity of patients and staff. Utilizes good hearing, vocal and visual skills. Requires frequent lifting up to 20 pounds and occasional lifting up to 50 pounds. Occasionally requires bending and stretching. Pushing and pulling. The incumbent works under good conditions in a clean environment. May be exposed to communicable diseases. No supervisory responsibilities.
EQUIPMENT : Computer and Printer
Copy Machine
Fax Machine
Telephone
The above statements reflect the general details considered necessary to describe the principal function of the job as identified and shall not be considered as a detailed description of all work requirements that may be inherent to this position.
