Biller and Coder Clinics Full Time Days
DUTIES INCLUDE BUT ARE NOT LIMITED TO Daily figures spreadsheet for all departments in Athena which includes tracking new and established patients, charges, payments, and current A/R.
Works billing worklist:
Applies unapplied credits and prepayments to balances as needed.
Adjusts prompt pays that did not get discounted and applied.
Works remittances:
Downloads virtual credit card payments from Athena.
Downloads EOBs for Athena from insurance companies and uploads to Athena.
Works claim worklist:
Reviews overpayments from insurances.
Sends inquiries for the insurance companies to take back their payments; monitors tracking and follow-up of take backs.
Processes patient refunds:
sends requests to A/P for a refund check, then posts and mails refund checks to patients.
Oversee and monitor 3rd party payer/provider/department enrollment processes and ensure timely communication of changes/updates to hospital clinics, PMDS and other impacted parties.
Collaborate with PMDS and other LifePoint hospitals/corporate departments to disseminate best demonstrated practices.
Ensure compliance with all relevant regulations, standards, and laws.
Periodically review clinic charge posting activities for compliance and adherence to accepted practices and documented processes, as well as assist in posting hospital clinic charges where responsibility is designated.
Review/respond to/resolve claim scrubs, front-end denials, back-end denials, and appeals where responsibility is designated, including providing training, feedback, and assistance to hospital clinics in preventing the recurrence of problematic claims Provide training, feedback and assistance to hospital clinic staff relating to pre-visit revenue cycle impacting processes, including demographic and insurance entry/information, patient TOS payment collection, eligibility verification, authorizations and provider credentialing.
Balances Medical Manager and runs end of month and end of year reports for accounting.
Sends out Medical Manager statements.
Runs end of month reports from Athena and sends to shared drive for accounting.
Runs referring provider report weekly for administration tracking.
Monitors clinics patient counts; new or established for administration.
Reviews news and message box for updates on insurance claims.
Works unpostable dashboard and unpostable correspondence dashboard.
Types dictation for outreach clinics.
Posts checks and/or adjustments in Athena as needed.
Reviews workflow dashboard and completes necessary tasks.
Maintains daily and monthly logs as required.
Answers the telephone in a professional and courteous manner; takes messages; directs calls to appropriate staff members.
Works on special projects as needed.
Other duties as assigned.
KNOWLEDGE, SKILLS & ABILITIES Ability to organize and coordinate patient information.
Ability to be flexible and function under stressful situations.
Ability to communicate effectively.
Basic computer knowledge Appropriate telephone etiquette as well as interpersonal skills to interact with providers, staff and patients.
Knowledge of medical terminology.
Ability to communicate with insurance companies and basic understanding of insurance processes EDUCATION High school diploma or equivalent.
EXPERIENCE Preferably a minimum of one year experience in a medical office setting Experience with medical billing or insurance preferred.
CPC Certification preferred but not required.
CERTIFICATE/LICENSE None required.
PHYSICAL DEMANDS/WORKING CONDITIONS Sedentary office position which involves long periods of time utilizing a computer for data input/typing Close vision, copying, reading, attention to detail.
Capability to explain and teach.
Hearing to normal range Potential exposure to communicable diseases, toxic substances, bodily fluids, medicinal preparations and other conditions common to a clinic environment.
Equal Opportunity Employer/Protected Veterans/Individuals with DisabilitiesThe contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.
However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information.
41 CFR 60-1.
35(c) Recommended Skills Administration Attention To Detail Billing Claim Processing Credentialing Interpersonal Skills Estimated Salary: $20 to $28 per hour based on qualifications.
Works billing worklist:
Applies unapplied credits and prepayments to balances as needed.
Adjusts prompt pays that did not get discounted and applied.
Works remittances:
Downloads virtual credit card payments from Athena.
Downloads EOBs for Athena from insurance companies and uploads to Athena.
Works claim worklist:
Reviews overpayments from insurances.
Sends inquiries for the insurance companies to take back their payments; monitors tracking and follow-up of take backs.
Processes patient refunds:
sends requests to A/P for a refund check, then posts and mails refund checks to patients.
Oversee and monitor 3rd party payer/provider/department enrollment processes and ensure timely communication of changes/updates to hospital clinics, PMDS and other impacted parties.
Collaborate with PMDS and other LifePoint hospitals/corporate departments to disseminate best demonstrated practices.
Ensure compliance with all relevant regulations, standards, and laws.
Periodically review clinic charge posting activities for compliance and adherence to accepted practices and documented processes, as well as assist in posting hospital clinic charges where responsibility is designated.
Review/respond to/resolve claim scrubs, front-end denials, back-end denials, and appeals where responsibility is designated, including providing training, feedback, and assistance to hospital clinics in preventing the recurrence of problematic claims Provide training, feedback and assistance to hospital clinic staff relating to pre-visit revenue cycle impacting processes, including demographic and insurance entry/information, patient TOS payment collection, eligibility verification, authorizations and provider credentialing.
Balances Medical Manager and runs end of month and end of year reports for accounting.
Sends out Medical Manager statements.
Runs end of month reports from Athena and sends to shared drive for accounting.
Runs referring provider report weekly for administration tracking.
Monitors clinics patient counts; new or established for administration.
Reviews news and message box for updates on insurance claims.
Works unpostable dashboard and unpostable correspondence dashboard.
Types dictation for outreach clinics.
Posts checks and/or adjustments in Athena as needed.
Reviews workflow dashboard and completes necessary tasks.
Maintains daily and monthly logs as required.
Answers the telephone in a professional and courteous manner; takes messages; directs calls to appropriate staff members.
Works on special projects as needed.
Other duties as assigned.
KNOWLEDGE, SKILLS & ABILITIES Ability to organize and coordinate patient information.
Ability to be flexible and function under stressful situations.
Ability to communicate effectively.
Basic computer knowledge Appropriate telephone etiquette as well as interpersonal skills to interact with providers, staff and patients.
Knowledge of medical terminology.
Ability to communicate with insurance companies and basic understanding of insurance processes EDUCATION High school diploma or equivalent.
EXPERIENCE Preferably a minimum of one year experience in a medical office setting Experience with medical billing or insurance preferred.
CPC Certification preferred but not required.
CERTIFICATE/LICENSE None required.
PHYSICAL DEMANDS/WORKING CONDITIONS Sedentary office position which involves long periods of time utilizing a computer for data input/typing Close vision, copying, reading, attention to detail.
Capability to explain and teach.
Hearing to normal range Potential exposure to communicable diseases, toxic substances, bodily fluids, medicinal preparations and other conditions common to a clinic environment.
Equal Opportunity Employer/Protected Veterans/Individuals with DisabilitiesThe contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.
However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information.
41 CFR 60-1.
35(c) Recommended Skills Administration Attention To Detail Billing Claim Processing Credentialing Interpersonal Skills Estimated Salary: $20 to $28 per hour based on qualifications.
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