What are the responsibilities and job description for the Medical Claim Biller (DOH/FBMC #13658) position at State of New Mexico?
Posting Details
This posting will be used for ongoing recruitment and may close at any time. Applicant lists may be screened mor than once.
Why does the job exist?
The purpose of this position is to ensure accuracy, completeness, and timeliness in establishing Nursing Facility Level of Cares (NFLOC) for the facility's resident population; submit monthly medical billing of Medicaid, Medicare, Medicare Replacement Plans, Private Insurance and Private Pay claims; the position submits and monitors the assigned portion of billing for long term care and skilled nursing services for the facility, assures correct data transfer and is responsible for obtaining and maintaining all documentation for medical billing, answers inquiries from insurance companies and patients, and explains all actions pertaining to the billing/accounting/collections processes; serves as a backup for the Accountant and Auditor Advanced in their absence.
How does it get done?
Under general supervision compiles required documentation to submit packets to MCOs (Managed Care Organizations) for approvals of NFLOCs to include monitoring submission deadlines and provide timely responses to inquiries to achieve authorization for services provided, submits monthly medical billing of Medicaid, Medicare, Medicare Replacement Plans, Private Insurance and Private Pay claims, submits and monitors the assigned portion of billing for long term care and skilled nursing services for the facility obtaining and maintains all documentation for medical billing, answers inquiries from insurance companies and patients, and explains all actions pertaining to the billing/accounting/collections processes.
Who are the customers?
Residents, Resident Representatives of Fort Bayard Medical Center.
Ideal Candidate
Residents, Resident Representatives of Fort Bayard Medical Center.
Minimum Qualification
Associate degree in Accounting, Finance, Auditing, or Business Administration and two (2) years directly related work experience in accounting, auditing, finance, and/or budgeting. Any combination of education from an accredited college or university in a related field and/or direct
experience in this occupation totaling four (4) years may substitute for the required education and experience.
Employment Requirements
Successful completion of a criminal background check is required. Successful completion of the Health Insurance Portability and Accountability (HIPPA) training.
Working Conditions
Works in office areas as well as throughout the facility.
Moves intermittently during working hours.
Is subject to frequent interruptions.
Is involved with residents, family members, and personnel.
Is subject to hostile and emotionally upset residents, family members and personnel.
Must be able to push, pull, move, and/or lift a minimum of 25 pounds to a minimum height of 5 feet and be able to push, pull, move, and/or carry such weight a minimum distance of 50 feet.
Supplemental Information
Do you know what Total Compensation is? Click here
Agency Contact Information: Florentina Rios (575)537-8667 Email
For information on Statutory Requirements for this position, click the Classification Description link on the job advertisement.
Bargaining Unit Position
This position is covered by a collective bargaining agreement and all terms/conditions of that agreement apply and must be adhered to.
This posting will be used for ongoing recruitment and may close at any time. Applicant lists may be screened mor than once.
Why does the job exist?
The purpose of this position is to ensure accuracy, completeness, and timeliness in establishing Nursing Facility Level of Cares (NFLOC) for the facility's resident population; submit monthly medical billing of Medicaid, Medicare, Medicare Replacement Plans, Private Insurance and Private Pay claims; the position submits and monitors the assigned portion of billing for long term care and skilled nursing services for the facility, assures correct data transfer and is responsible for obtaining and maintaining all documentation for medical billing, answers inquiries from insurance companies and patients, and explains all actions pertaining to the billing/accounting/collections processes; serves as a backup for the Accountant and Auditor Advanced in their absence.
How does it get done?
Under general supervision compiles required documentation to submit packets to MCOs (Managed Care Organizations) for approvals of NFLOCs to include monitoring submission deadlines and provide timely responses to inquiries to achieve authorization for services provided, submits monthly medical billing of Medicaid, Medicare, Medicare Replacement Plans, Private Insurance and Private Pay claims, submits and monitors the assigned portion of billing for long term care and skilled nursing services for the facility obtaining and maintains all documentation for medical billing, answers inquiries from insurance companies and patients, and explains all actions pertaining to the billing/accounting/collections processes.
Who are the customers?
Residents, Resident Representatives of Fort Bayard Medical Center.
Ideal Candidate
Residents, Resident Representatives of Fort Bayard Medical Center.
Minimum Qualification
Associate degree in Accounting, Finance, Auditing, or Business Administration and two (2) years directly related work experience in accounting, auditing, finance, and/or budgeting. Any combination of education from an accredited college or university in a related field and/or direct
experience in this occupation totaling four (4) years may substitute for the required education and experience.
Employment Requirements
Successful completion of a criminal background check is required. Successful completion of the Health Insurance Portability and Accountability (HIPPA) training.
Working Conditions
Works in office areas as well as throughout the facility.
Moves intermittently during working hours.
Is subject to frequent interruptions.
Is involved with residents, family members, and personnel.
Is subject to hostile and emotionally upset residents, family members and personnel.
Must be able to push, pull, move, and/or lift a minimum of 25 pounds to a minimum height of 5 feet and be able to push, pull, move, and/or carry such weight a minimum distance of 50 feet.
Supplemental Information
Do you know what Total Compensation is? Click here
Agency Contact Information: Florentina Rios (575)537-8667 Email
For information on Statutory Requirements for this position, click the Classification Description link on the job advertisement.
Bargaining Unit Position
This position is covered by a collective bargaining agreement and all terms/conditions of that agreement apply and must be adhered to.
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