What are the responsibilities and job description for the Billing Technician Closes 12/27/24 position at United Indian Health Services, Inc?
SUMMARY
The primary purpose of this position is the overall responsibility for a major segment of the accounts receivable management function. This responsibility includes the submission of properly executed claims on a timely basis to third party payers and responsible parties including rebilling or corrected billing of accounts previously submitted.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
- Prepares and submits claims to third party payers, intermediaries and responsible parties according to established UIHS policy and procedures
- Maintains and controls unbilled claims for an assigned section of patient receivables
- Verifies all control functions assigned are maintained daily as set forth in clinic policies and procedures
- Reviews delinquent patient account records; follow up with responsible parties via telephone and correspondence according to clinic policies and procedures. Performs telephone contact with third party payers for amounts due.
- Reviews billing queue daily to identify claims ready for billing
- Performs error correction for all rejected/suspended claims previously submitted to third party payers and intermediaries and patients according to clinic policies and procedures
- Submits report to supervisor on a monthly basis of all claims deemed uncollectable, including with reason(s)
- Posts insurance and patient payments to appropriate accounts in Nextgen. Ensures all payments received are matched to appropriate balance on encounters
- Maintains knowledge by reading all third party newsletters, periodicals and updates circulated by management. Attends all continuing education opportunities made available
- Applies a number of substantive guidelines. Uses judgment in locating and selecting appropriate guidelines, references and procedures for application and in making minor deviations to adapt the guidelines to specific cases.
- Maintains regular and recurring contact with employees of the clinic, local/state agencies, third party payers and Medicare and Medicaid fiscal intermediaries. Assists with claims submission and resolution of problems pertaining to billing of claims in order to resolve issues for any returned claims for services rendered to Indian Beneficiaries and Non-Beneficiaries alike.
- Prepares and sends patient statements and invoices for any balance owing on accounts, on a monthly basis
- Adheres to all HIPAA guidelines/regulations
- Attends to questions in courteous manner to patients, co-workers, providers, insurance companies and other business partners
- Identifies and helps resolve patient billing complaints
- Maintains files accurately and efficiently
- Attends staff meetings and other meetings as assigned
SUPERVISORY RESPONSIBILITIES: This position has no supervisory responsibilities.
QUALIFICATIONS:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EDUCATION /EXPERIENCE: Educational degrees must be from a US Department of Education accredited school
- Must have High School Diploma or equivalent and ability to type 35 wpm for all levels of position
Level I
- High School diploma or equivalent
- Two (2) years direct experience
- Knowledge and understanding of established and standardized business office procedures and clinic policies sufficient to handle duties
- Working knowledge of ICD-10-CM and CPT/HCPCS coding terms in order to interpret and resolve problems based on information derived from system monitoring reports and the UB 04, HCFA-1500 and ADA billing forms submitted to the third party payer.
Level II
- All education and skills listed above and;
- Three (3) years direct experience
- Thorough knowledge of all third party claims submission processes and attendance at continuing education opportunities made available through management to stay current on changes
- Knowledge of how to establish and maintain relationships with the third party payer community necessary for resolution of outstanding claims
Level III
- All education and skills listed above and;
- Four to Five (4-5) years direct experience, or
Associates Degree
- Two (2) years direct experience
- Providing leadership to others through example and sharing of knowledge/skill
- Must be able to assist billing specialist with training staff on new processes
COMPUTER OPERATIONS
- Proficient personal computer skills including electronic mail, record keeping, routine database activity, word processing, spreadsheet and graphics, etc.
