Performs billing of clinical services rendered, such as examinations, treatments and procedures, to patients and government or private insurance carriers.
Determines appropriate charges based on services provided; performs billing.
Reviews patient accounts to ensure accuracy and completeness of claims billing for maximum reimbursement.
Reviews Explanations of Benefits from third party payers to determine if payment was made correctly and if denials can be re-billed.
Analyzes and maintains reports to ensure timely submission of claims.
Identifies problem accounts requiring further work.
Provides information to insurance carriers or patients regarding patient accounts.
Assists patients with billing problems.
Notifies supervisor of ongoing problems.
Maintains files on all documentation such as charge slips, Explanations of Benefits, and client or patient information.
Prepares and distributes reports.
Refers accounts to collectors in accordance with policy.
Performs other related duties as assigned or requested.
Minimum Education: High School or equivalent
Minimum Experience: 2 Years Combined education/experience as substitute for minimum experience
Minimum Field-of-Expertise: Medical services billing, experience with Medicare and private third party payors, and computerized billing systems such as IDX
Preferred Education: Bachelors Degree
Preferred Experience: 3 Years
Assemble and organize numerical data
Draft routine correspondence
Communicate with others to gather information
Maintain filing systems
Translate from one language to another
Use computerized spreadsheets
Problem Solving - Identifies and resolves problems time efficiently; Gathers and analyzes information; Develops solutions; Uses reason.
Technical Skills - Assesses own strengths and weaknesses; Pursues training and development opportunities; Strives to continuously build knowledge and skills; Shares expertise with others.
Interpersonal Skills - Listens to others attentively; Remains open to others' ideas and tries new things.
Oral Communication - Speaks clearly and persuasively; Listens and gets clarification when necessary; Responds informatively to questions.
Written Communication - Writes clearly and concisely; Edits work; Presents numerical data effectively; Able to read and interpret written information.
Planning/Organizing - Prioritizes and plans work activities; Uses time efficiently; Plans for additional resources; Sets goals and objectives; Organizes or schedules other people and their tasks.
Professionalism - Approaches others in a polite and tactful manner; Maintains composure and reacts well under pressure; Treats others with respect and consideration; Accepts responsibility for own actions; Follows through on commitments.
Quality - Demonstrates accuracy and thoroughness; Applies feedback to improve performance; Monitors own work to ensure quality.
Ability to work with mathematical concepts such as probability and statistical inference.
Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, and percentages.
Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
Occasionally required to sit.
Occasionally required to walk.
Occasionally required to use hands to finger, handle, or feel.
Occasionally required to reach with hands and arms.
Occasionally required to talk or hear.
Occasionally required to bend, lift or climb.
Occasionally required to lift light weights (less than 25 pounds).
Occasionally required to lift moderate weights (25-50 pounds).
Occasionally required to lift heavy weights (50 pounds or greater).
Finger dexterity required.
Hand coordination required.
Specific vision abilities required for this job include: close vision, distance vision, ability to adjust or focus.
Exposure to adverse conditions.
Exposure to extreme heat.
Exposure to extreme cold.
Exposure to wet and/or humid conditions.
Exposure to moving mechanical parts.
Exposure to high, precarious places.
Exposure to fumes or airborne particles.
Exposure to toxic or caustic chemicals.
Exposure to outside weather conditions.
Possible risk of electrical shock
Exposure to explosives
Possible risk of radiation and vibration.
Protective clothing or equipment is required including: gloves, helmets, steel-toed boots, protective eyewear.
The noise level in the work environment usually is __________
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