What are the responsibilities and job description for the Billing Specialist position at Gerald L. Ignace Indian Health Center, Inc.?
JOB SUMMARY:
The overall responsibility is for a major contribution to the revenue cycle/accounts receivable operation and patient registration function(s) for the Gerald L. Ignace Indian Health Center, Inc. The responsibility includes the submission of properly executed claims on a timely basis to third party payers, guarantors, and other responsible parties. Re-billing, corrections and follow up of claims. Ensuring that correct and accurate patient information is correctly obtained and maintained in the patient registration system.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. While performing the duties of this job, the employee is regularly required to sit; use hands to manipulate objects, tools or controls; reach with hands and arms; and talk and hear. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus. Noise level in the work environment is usually quiet.
Work is performed in an office environment utilizing various office equipment including, but not limited to, a computer, copy machine, fax machine, and multi-line phone. Ability to communicate effectively over the telephone, by computer and in person. Ability to perform well in a fast-paced work environment.
This is a general outline of the essential functions of this position and shall not be construed as an all-inclusive description of all work requirements and responsibilities. The employee may be required to perform other job-related duties as requested by the designated work leader(s). All requirements are subject to change over time. All positions at the Gerald L. Ignace Indian Health Center have the responsibility to carry out functions to maintain inspection and survey readiness, participate in Quality Improvement initiatives, as well as assist in and/or provide education for health promotion and disease prevention. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.
GLIIHC supports a safe, healthy and drug-free work environment through criminal and caregiver background checks and pre-employment drug testing. GLIIHC maintains a smoke-free environment.
The Gerald L. Ignace Indian Health Center, Inc. provides equal employment opportunities to applicants and employees without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disability. Equal Opportunity employer/Veteran/Disabled. American Indian and Veteran Preference employer.
The overall responsibility is for a major contribution to the revenue cycle/accounts receivable operation and patient registration function(s) for the Gerald L. Ignace Indian Health Center, Inc. The responsibility includes the submission of properly executed claims on a timely basis to third party payers, guarantors, and other responsible parties. Re-billing, corrections and follow up of claims. Ensuring that correct and accurate patient information is correctly obtained and maintained in the patient registration system.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Responsible for the accurate and timely submission of claims to third party payers, intermediaries, and responsible parties.
- Responsible for the maintenance and control of unbilled claims
- Verifies that all billing control functions are completed daily
- Reviews that claims are generated daily and bills are approved and submitted each day
- Responsible for the error correction for all rejected/suspended claims previously to third party payers and intermediaries and patients.
- Provides supervisor with accurate accounting of all claims.
- Assists with Patient Registration data and ensures that all patient information is entered correctly on a daily basis.
- Uses coding conventions, techniques, coding rules and regulations.
- Keeps up to date on all coding trends and changes.
- Identifies inconsistencies among documentation and discusses with appropriate provider (e.g., legibility, diagnoses, procedures, medications).
- Assist with responsibilities and job duties of Accounts Receivable, including posting payments to outstanding claims.
- Assist with all responsibilities of the billing process.
- Assist and/or process third party insurance credentialing.
- Performs related duties as assigned by the Billing Office Manager.
- Must have a working knowledge of the International Classification of Diseases (ICD-9-CM, ICD-10-CM), current Procedural Terminology (CPT-4) coding, and medical terminology.
- Must have a working knowledge of various federal, state, and local laws, policies, regulations, and precedents as they pertain to their-party reimbursement.
- Must have experience using basic office equipment including telephones, copiers, and fax machines.
- Knowledge of Medical/Behavioral Health records and the patient registration process, eligibility requirements, and successful interview techniques to ensure demographic information is collected and accurately entered into system.
- Prefer perform highly specialized technical medical/behavioral health records’ functions, such as a comprehensive qualitative review and analysis of charts, an in-depth record analysis; selection and assignment of correct diagnosis, operation and procedural codes, CPT-coding, ICD-9-DM and ICD-10-DM coding, assuring presence of all component parts of patient charts, records are valid, and meet all established guidelines and standards; summarizing and analyzing all pertinent data, retrieving and compiling record data, generating reports, reviewing of patient charts in detail for deficiencies, incomplete or missing reports.
- Practical knowledge of anatomy, physiology, disease processes, medical terminology, extensive knowledge of ICD-9, CPT-9 and CPT-4 coding procedures.
- Preferred associate degree in related field.
- Must be proficient in the English language. Bilingual preferred.
- Must have strong interpersonal skills and strong organizational skills.
- Must have excellent verbal and written communication skills.
- Must have a working knowledge and proficiency in Word Processing and Data Systems management.
The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. While performing the duties of this job, the employee is regularly required to sit; use hands to manipulate objects, tools or controls; reach with hands and arms; and talk and hear. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus. Noise level in the work environment is usually quiet.
Work is performed in an office environment utilizing various office equipment including, but not limited to, a computer, copy machine, fax machine, and multi-line phone. Ability to communicate effectively over the telephone, by computer and in person. Ability to perform well in a fast-paced work environment.
This is a general outline of the essential functions of this position and shall not be construed as an all-inclusive description of all work requirements and responsibilities. The employee may be required to perform other job-related duties as requested by the designated work leader(s). All requirements are subject to change over time. All positions at the Gerald L. Ignace Indian Health Center have the responsibility to carry out functions to maintain inspection and survey readiness, participate in Quality Improvement initiatives, as well as assist in and/or provide education for health promotion and disease prevention. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.
GLIIHC supports a safe, healthy and drug-free work environment through criminal and caregiver background checks and pre-employment drug testing. GLIIHC maintains a smoke-free environment.
The Gerald L. Ignace Indian Health Center, Inc. provides equal employment opportunities to applicants and employees without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disability. Equal Opportunity employer/Veteran/Disabled. American Indian and Veteran Preference employer.