Time as Reported Grade 008 Dialysis-Cardiovascular Nrsg Schedule 7AM-5PM; SATURDAYS 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 collection. Acts as the receptionist for the unit during normal business hours including business operations. Typical Duties: Coordinates daily efforts to edit and correct registration and billing errors, monitors charge entry and reconciliation of area charges, ensures accuracy of patient schedules, identifies ways to reduce follow-up, repetitive or corrective work. 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 balanced at the point of rendered service site for daily front end collections.Ensures monies received at time of service are properly recorded and balanced.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. Acts as the receptionist for the unit welcoming patients and directing them to assigned area for treatment. Utilizes transportation systems, dietary systems and other to meet the needs of the patients and unit. Performs filing and other desk functions as required. Serves as a focal point for handling complaints, utilizes service recovery concepts, serves as front-line problem solver. Qualifications Associateâ™s degree in Medical, Secretarial or related field and 2-3 years of experience required; or an equivalent combination of education and experience 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 and ICARE values to patient, families and staff.
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