Overview JOB DUTIES Responsible for obtaining appropriate demographic and financial information. Registers patients and completes necessary documentation. Add or update patient histories as needed. Research charges for appropriate carrier code and financial class. Code and key physicians’ charges into automated billing system program. Utilize resources and tools in the resolution of invoices following Company Policy for assigned special projects, payors, and/or place of service. Resolving outstanding balances with communication with internal and external personnel. Responsible for handling specialized accounts from charge through payment. Essential Functions • Verify completeness of registration information. Add and/or update as needed, Verify and/or Assign financial class and code appropriately, Verify and Enter patient demographic information utilizing automated billing system, Verify Insurance coverage utilizing various online software tools. • Verify and enter appropriate billing information utilizing facility computer systems. Verify and/or Assign CPT, ICD-10 and Modifier codes are utilized for each patient encounter, as needed. Verify and/or Assign Key Data Elements for charge entry such as; Location Codes, Provider #’s, Authorization #’s, Referring Physician, code and enter charges, as needed. • Inform Team Leader on the status of work and unresolved issues. Alert Team Leader of backlogs or issues requiring immediate attention, as well as any unresolved issues. Contact insurance companies to ascertain the status of claims and identify additional information needed. Research and take appropriate action in regards to refunds, charge corrections, etc. with the ability to identify refund trends, as assigned. Review and work assigned WQs on a daily basis to make any corrections, resolve edits, and submit to the payor. • Work A/R, including correspondence. Documents notes in the automated billing system regarding patient inquiries, conversations with insurance companies, clinics, etc. for all actions. • Identify payor issues. Review PSR requests and determine course of action. • Ability to recognize when a referring provider, authorization and/or a referral is needed and perform necessary research to identify same, utilizing other EMR systems, web portals, as needed. Knowledgeable regarding process to have a new provider added to EPIC. • Identify trends by payor that impact A/R and communicate to leadership (Denials, payment transfers, etc.). • Provides essential reporting functions as required. • Perform special projects assigned by the Team Leader or Manager. • Ability to work overtime as needed based on the needs of the business. Temperament Adhere to company policies and procedures, demonstrate the core values and Hospitality behaviors, resolve conflict through open, honest, professional communication, demonstrate positive and enthusiastic attitude, keep supervisor and leadership apprised of issues, and seek opportunities to recognize others. Qualifications Skills, Knowledge, Abilities • Ability to recognize the need to establish an appropriate account utilizing Company Policy. • Ability to enter charge information into EPIC. • Ability to correct edits timely and as appropriate. • Ability to identify payer specific coding guidelines, billing edits, National Correct Coding Initiative, and online tools. • Ability to operate standard business equipment, e.g., copier and fax machine. • Strong telephone skills, payor websites and other online payor tools, preferred. • Strong analytical and problem solving skills, 10 key proficiency. • Excellent interpersonal and communication skills. • Ability to work as a team is essential to the individual's success. • Knowledge of third party reimbursement. • Average typing speed of 35 WPM with minimal errors. • Computer literate with proficiency in Microsoft Office (Outlook, Word, Excel, Access, and Power Point), Adobe Acrobat, 10-key, and database management. • Knowledge of procedure and diagnosis coding and medical terminology. Experience Requirements 3 years Health care experience in medical billing or related position preferred 3 years Computer experience in medical billing preferred 3 years Medical Billing system preferred Education Requirements High School Diploma required Associates preferred Medical Terminology Course preferred UFJPI is an Equal Opportunity Employer and Drug Free Workplace