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Summary:
Responsible for the processing of billing and collection of all charges for all direct services provided at Health Services to patients/clients to Third Party Billing vendor. Posts all insurance payments and necessary adjustments and follows up on outstanding claims for payment.
Duties & Responsibilities:
Submits claims to Third Party Billing vendor for third party and government insurances.
Posts all payments received from third party and government insurance companies.
Applies necessary payment adjustments as they apply to Health Center patients/clients.
Follows-up on outstanding claims for payments.
Works with insurance companies on behalf of the clients regarding billing and insurance issues.
Maintains an accurate year-to-date log of the number of claims submitted and total dollar amount of charges billed; submits monthly reports to Revenue Cycle Manager.
Processes month end AR/collection reports and provides to all necessary Health Services and Finance staff.
Monitors outstanding AR and provides detailed monthly collection reports to Revenue Cycle Manager.
Verifies accuracy of billing data and revises any errors.
Reviews and retains medical records in order to compute fees and charges due.
Participates in Utilization Review Committee meetings and reports billing related data.
Adheres to all Oneida Indian Nation Health Center services security and confidentiality policies and procedures in regards to all daily job functions and receives annual up-date training regarding each area.
Performs other duties as assigned.
Minimum Qualifications:
High School Diploma or Equivalency.
Two to three years experience in a medical billing or insurance office.
Must be familiar with Medicare and Medicaid Billing, including their reimbursement rates and guidelines.
Ability to understand the varying complexities of medical billing; this extends to different types of insurance plans and government assisted programs.
Experience with Accounts Receivable and Collections.
Must be familiar with Electronic Medical Records (EMR).
Must have a working knowledge of CPT and ICD-9 coding.
Computer experience to include Microsoft Word and Excel.
Strong communications skills.
Strong logistical skills, along with industry standard computer software literacy and a firm understanding of medical legality preferred.
