Responsive recruiter
General Summary
Performs a variety of complex clerical and accounting functions for patient billing, including verification of invoice information, maintenance of third party billing records, and resolution of a variety of problems. Follows up on submitted claims and patient billing; resubmits claims or resolves problems. Works with others in a team environment.
Primary Responsibilities
1. Processes claims to patients and other payers and maintains supporting documentation files.
2. Researches and responds in person, by telephone, or in writing to patient or insurance carrier inquiries regarding billing questions.
3. Follows up on submitted claims; monitors unpaid claims, initiates tracers with EHR software; re-file claims as necessary with standard billing cycle time frame, either electronically, on paper, or on insurance provider web portals.
4. Posts and reconciles payments to patient account inquiry; checking each insurance payment for accuracy based on contracted fees.
5. Identifies and bills secondary and tertiary insurance companies.
6. Reviews accounts receivable and make recommendations to supervisor on delinquent accounts.
7. Reviews and analyzes patient records; keeps track of patient data over unpaid multiple visits.
8. Follows up on appeals, denials, and rejected claims with insurance carriers.
9. Maintains billing/filing records in accordance with established protocol.
10. Ensures strict confidentiality of financial records as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
11. Ensures that recorded CPT/ HCPCS/ ICD codes reflected in providers documentation comply with insurance carriers, federal, and state guidelines.
12. Maintains knowledge of ICD/CPT/HCPCS coding and any FQHC specific coding requirements necessary to ensure best practices are applied in the revenue cycle.
13. Performs other duties as assigned.
14. Promotes and adheres to CACOST core values (Accountability, Excellence, Integrity, Quality and Teamwork).
Work Experience
- Minimum of one year experience in medical office setting.
- Three years of prior employment experience in medical billing.
- Multi-speciality group coding and billing
Education/Certifications/Licensure
- High school degree or equivalent;
- Medical Coding Certificate; RHIT or CPC by AAPC or AHIMA license; meet state licensure requirements.
Skills
- Computer skills and experience in maintaining automated recordkeeping systems
- Knowledge of Electronic Medical Record software; Microsoft Office Suite and Google Drive.
- Good communication skills, written and oral, are necessary.
- Ability to work independently or as an active member of a team.
- Ability to multitask, prioritize, and manage time efficiently.
- Accurate and precise attention to detail.
- Goal-oriented, organized team player.
- Prefer bilingual in English and Spanish.
- Knowledgeable about government regulations and insurance payer policies on healthcare and ensure that coding meets acceptable standards.
- Understanding of medical terminology, anatomy and physiology.
Physical RequirementsIf a preliminary offer of employment is extended, a physical will be required before the offer can be accepted.
Light to medium physical duties include sitting, standing, walking, reaching, bending, hearing, and talking for up to eight(8) hours a day. Must have good vision; with or without corrective lenses. Must be able to lift twenty (20) pounds. Lifting will be primarily confined to occasional on premises lifting of boxes of office supplies and minor office equipment.
Welcome to Community Action Corporation of South Texas (CACOST)!
CACOST is a private non-profit organization established in 1971 and funded through federal, state and local grants. CACOST currently serves 16 counties via a wide variety of community programs and services. CACOST lives its mission each day, which is to continuously improve the lives of South Texans by providing high quality health care, education, housing and economic opportunities to reduce poverty through services and partnerships.
CACOST is looking for employees who are interested in accomplishing our mission, which can be both rewarding and challenging. We count on our employees to contribute directly to the growth and success of our agency. Because the quality of our staff is the key to our success, we carefully select our new employees. Apply today to join our CACOST family and take pride in being a member of our team.
