POSITION NARRATIVE: Responsible for processing superbills by entering CPT/ICD-9 codes assessing accuracy and optimal reimbursement. Additional duties include but are not limited to insurance verification, resolving billing questions and problems, auditing accounts, writing appeal letters and processing refunds. Reports to Business Office Manager.
ESSENTIAL FUNCTIONS:
- Responds timely to all incoming superbills, processing charges within 48 hours and communicates possible problems to specialty departments and business office manager.
- Solves billing questions/problems and audits accounts.
- Understand and adheres to the insurance carrier’s claim submission and appeal process.
- Makes necessary corrections to patient accounts and charges for accurate electronic submission.
- Processes accounts receivable.
- Prioritizes daily workload to best increase reimbursement and decrease A/R days.
- Reviews and corrects any errors or missing information on electronic claims, attaches necessary documentation for payment if required.
SKILLS, KNOWLEDGE & ABILITIES:
- Skills: Strong customer service, written and verbal communication skills; word processing and spreadsheet skills; 10-key by touch and typing 35 wpm.
- Knowledge: Insurance billing procedures and collection laws; medical terminology, ICD-9 and CPT codes.
- Abilities: Work effectively with patients and co-workers; prioritize tasks; identify collection problems; work independently; meet deadlines; and prepare records in accordance with detailed instructions.
REQUIREMENTS: High School diploma or GED required. College level courses or Associate’s degree preferred. Two years patient service experience in a health care organization, preferably in insurance billing and accounts receivable.
PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is required to sit, and use wrist deviation, hand/wrist repetitions, and manual dexterity. The employee must occasionally stand, walk, twist, bend, squat/kneel, reach, grasp and lift up to 10 lbs. Specific vision and hearing required by the job includes close eye work, and normal hearing.
WORK ENVIRONMENT: Arch Health Partners maintains a drug free workplace, and smoke free working environment. Employees are required to successfully pass a pre-employment drug screen. Smoking is not permitted on the campus.
This position works in a well-lit, air-conditioned, office setting with moderate noise level. This position is not exposed to hazardous exposures, ionizing radiation, or requires personal protective equipment.
