Duties and
responsibilities
1. Philosophy
a) Supports the center's ideology, mission, goals, and objectives
b) Performs in accordance with the center's policies and procedures
c) Follows the center's standards for ethical business conduct
d) Conducts self as a positive role model and team member
e) Recognizes patients' rights and responsibilities and supports them in performance of job duties
f) Participates in center committees, meetings, in-services, and activities
2. Communication
a) Communicates effectively and professionally with patients, visitors, physicians, and coworkers
b) Interacts with others in a positive, respectful, and considerate manner
3. Financial practices
a) Uses center resources appropriately and avoids wasteful practices
b) Reports wasteful practices
c) Analyzes work area and makes recommendations for potential cost-effective improvements
4. Compliance program
a) Contributes to the progress and development of the center's adopted compliance program
b) Performs according to established compliance policies and procedures
5. Performance-improvement program
a) Contributes to the progress and development of the center's adopted performance-improvement program
b) Performs according to established performance-improvement policies and procedures
6. Safety/risk-management program
a) Adheres to safety policies and procedures in performing job duties and responsibilities
b) Reports observed or suspected safety violations, hazards, and policy/procedure noncompliance to the safety officer or other designated person
7. Professional competence
a) Participates in continuing education and other learning experiences
b) Shares knowledge gained in continuing education with staff
c) Maintains membership in relevant professional organizations
d) Seeks new learning experiences by accepting challenging opportunities and responsibilities
e) Welcomes suggestions and recommendations
8. Insurance billing duties
a) Codes each encounter, enters all codes and charges into the practice management system and sends claims to insurance companies
b) Runs daily batch report for billing and balances to daily schedule of fees charged
c) Understands and abides by billing compliance regulations
d) Submits claims to patient's secondary insurance (including primary carrier's EOB) after receiving correct payment from primary carrier
9. Collections duties
a) Runs reports on outstanding insurance A/R on a daily/weekly basis
b) Calls insurance companies to determine status on all accounts more than 45 days old
c) Sends any necessary copies or supporting documentation required by insurance companies
d) Notes contact with insurance companies in the practice management system
e) Runs reports on outstanding patient A/R on a daily/weekly basis
f) Makes telephone contact with all patients with balances more than 45 days old with no payment
g) Notes contact with patients in practice management system
h) For patient account balances of more than 90 days with no payment, advises Center Director, who will determine whether account is to be turned over for collection
i) Sends approved accounts to collection agency
j) If it is determined that a refund is due to the insurance company, completes refund-request form with supporting documentation, copy of EOB, etc. and submits to Center Director.
10. Billing calls/correspondence
a) Receives all calls related to patient bills, whether from patients or insurance companies
b) Answers billing questions in a clear and polite manner; pulls patient charts/computer files as necessary to answer questions
c) Forwards all complex problems or issues and any questions regarding refunds to Center Director
d) Answers all letters from insurance companies regarding questions or requests for information
e) Understands patient confidentiality laws and what signatures are required to release information
f) Follows up with Center Director on any problem claims regarding coding/charges
11. Performs other miscellaneous office/clerical duties as needed
Responsibility for assets
Responsible for accuracy and timeliness of billing directly related to accounts receivable.
Qualifications
1. Cooperative work attitude toward co-employees, management, patients, visitors, and physicians
2. Ability to promote favorable center image with physicians, patients, insurance companies, and general public
3. Ability to make decisions and solve problems
Requirements
Required
1. High school diploma or GED certificate
2. Training/courses in business office activities
3. Third-party-payer billing experience
4. Strong ethical and moral character references
Preferred
1. Certified Coder
2. Two or more years' billing experience
3. ASC billing experience
Job quality
requirements
1. Accuracy
2. Attention to detail
3. Timeliness
4. Organization
5. Little supervision needed to accomplish task
Dependability
1. Attendance
2. Punctuality
3. Ability to follow instructions
4. Ability to meet deadlines
Physical/mental requirements
1. Ability to sit, stand, and walk
2. Visual and auditory acuity for frequent use of computer, telephone, and occasional use of other office equipment
Working conditions
(environmental)
1. Well lit and ventilated, with non-hazardous and hazardous equipment
2. Category III: exposure to bloodborne pathogens and may encounter chemical hazards
Reports to
Center Director
Supervises
Not applicable
Contacts
1. Patients
2. Patients' family/significant others
3. Physicians and physician office personnel
4. Insurance company personnel
5. Center personnel
6. Administration
Compensation
$25-35/hour