Full Time 40 hours Grade 008 URMFG Business Office Schedule 8 AM-4:30 PM Responsibilities Position Summary: Under minimal direction and considerable latitude for independent judgment, performs charge entry functions for rendered services from an inpatient or outpatient setting. Responsible for an effective claim submission process to obtain maximum revenue collected. Typical Duties: Creates batches from reports of closed encounter forms, inpatient charge sheets, etc. obtained from the electronic medical record (EMR). Verifies the accuracy and completeness of all information such as demographics, insurance company, diagnosis, modifiers, etc. Determines correct method of resolving discrepancies by utilizing internal and external resources. Collects missing data and corrects registration errors accordingly. Independently reviews and researches multiple places within the EMR for each encounter or procedure to ensure that all opportunities for billing can be utilized. Examines notes in the medical record in order to abstract medical information relevant to patient encounter to determine appropriateness of potential charge submissions. Enters charges timely and accurately in the applicable billing system based on type of service and location. Correctly identifies diagnosis codes and charges are appropriate for claims to be effectively released and submitted to the assigned insurance carrier(s). Troubleshoots any problems within billing system that prevents claims from being released for acceptance by insurance carrier(s). Identifies cause of edit and independently resolves issue by reviewing the patient encounter to understand the nature of the problem. Researches information within the EMR using knowledge of insurer requirements to determine solution. Collaborates with office staff assigned to collections activity on unpaid, underpaid or denied claims following processing by insurance carrier(s). Gathers relevant detail from patient encounter and provides input for resolution and collection of revenue. Balances batches entered to a deposit ticket prepared and balances at the point of rendered service site for daily front end collections. Ensures monies received at time of service are properly recorded and balances. Makes appropriate contact when discrepancies are discovered and facilitates resolution through follow up activities. Acts as point of contact for patient billing questions at provider sites, answers procedural/process questions by office staff, and researches complicated accounts and patient complaints for resolution. Qualifications: Associateâ™s Degree in Medical, Secretarial, or related field and 2-3 years of experience required or certification obtained from a nationally accredited billing program (i.e., Certified Medical Billing Specialist CMBS, Certified Medical Records Technician CMRT, Certified Medical Reimbursement Specialist CMRS) ; or an equivalent combination of education and experience. Medical Terminology and experiences with billing, collection and electronic medical records preferred. Demonstrated customer relations skills.
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