Ashbaugh Beal
Central Billing Representative I
Ashbaugh Beal, Albuquerque, New Mexico, United States, 87101
Overview
Job Title: Central Billing Representative I Department: Central Billing Position Category (330): Fiscal and Billing Staff (L30b) Position Category (Rphca): Administration Staff Union Exempt: Yes The following statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Responsibilities
Under the direct supervision of the Director of Revenue Cycle Management, the Central Billing Representative I is responsible for maintaining a high-performance work environment characterized by positive relationships and a strong orientation towards customer service and timely quality patient billing. The Central Billing Representative I is responsible for direct interaction and assistance to Site Biller Representatives, patients, physicians, colleagues, contractors and consultants for the purpose of billing, collection and reporting of multi-specialty self-pay, third party payer accounts receivable and claims on a daily basis. Review site batched patient encounters for charge and payment accuracy, including encounter rate and other necessary billing adjustments. Monitor and review site unbilled encounters and assist to meet mutual daily and weekly deadlines. Provide education on encounter batches to minimize error recurrence and support maximum reimbursement. Meet all end-of-month closing activities and deadlines. Coordinate electronic patient statements on a monthly basis. Post payments received and reconcile system postings to lockbox and/or EOB totals. Record NSF checks and notify patients of adjusted balances due. Review credit balance reports and prepare refund requests for overpayments. Participate in billing Helpdesk customer support by receiving, responding and documenting all incoming account inquiries related to billing issues. Review assigned outstanding accounts receivable to identify problems with insurance payers; follow up on all assigned payer type accounts to facilitate collection of balances. Review and resolve all EOBs to initiate clean claim resubmission and reimbursement. Edit and submit insurance claims for fee-for-service and prospective payment system reimbursement. Resolve unapplied cash, reconcile cash postings and adjust payment allocations to payer types. Communicate payment terms and establish payment plans for overdue balances; monitor compliance. Evaluate uncollectible accounts and make recommendations concerning write-offs or bad debt status. Complete bad debt processes as directed; document activities in the practice management system and MS Word tools. Initiate and complete account adjustments to fix balances and comply with contractual and sliding scale requirements. Assist and train other staff in registration and billing; assist Site Biller Representatives in their absence. Responsible for all other duties as assigned. Requirements
MINIMUM EDUCATION AND EXPERIENCE High school degree or GED One to three years data entry, billing and claims experience in a healthcare setting or FCCH billing externship; related education may substitute for experience Experience in a multispecialty clinic setting Preferred licenses/certifications Certified Coder (medical and/or dental); Billing Certificate from a certified billing program; Coder/Billing certificates may be substituted with demonstrated knowledge of CPT, ICD-10, and dental coding KNOWLEDGE, SKILLS, AND ABILITIES General knowledge of computerized practice management systems; familiarity with Cerner PWPM, Cerner EHR, and Dentrix preferred Ability to learn billing and collection systems in federally chartered CHC and RHI/UHI programs Effective communication with tact and diplomacy with diverse groups, including staff, providers, and insurers Ability to manage multiple assignments with deadlines; work with others in a team environment Knowledge of HIPAA related to medical, dental, and behavioral health billing High level of accuracy and attention to detail; ability to communicate effectively in writing and orally Ability to respond to sensitive inquiries or complaints; work independently with minimal supervision Proficiency with computers and MS Windows; knowledge of FQHC billing and reimbursement preferred Working knowledge of CPT, Dental ADA, DSM V and ICD-10; knowledge of Medicare and Medicaid guidelines; knowledge of UB04 and HCFA1500 forms Familiarity with compliance programs and willingness to comply with laws and regulations Physical Characteristics/Working Conditions
Able to prioritize and respond to diverse demands; periodic travel within the Albuquerque metropolitan area; standard office environment Physical effort and dexterity: good dexterity for computer use; occasional lifting and carrying related to office duties Machines/Tools: capable of using office machines and personal computers Visual/Hearing/Speaking: able to read monitor outputs and clearly communicate for work and safety Work schedule: primarily Monday–Friday; weekends or evenings may be required to meet deadlines Seniority level
Entry level Employment type
Full-time Job function
Accounting/Auditing and Finance Industries
Law Practice Note: This description includes standard job information and may include legally required EEO statements.
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Job Title: Central Billing Representative I Department: Central Billing Position Category (330): Fiscal and Billing Staff (L30b) Position Category (Rphca): Administration Staff Union Exempt: Yes The following statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Responsibilities
Under the direct supervision of the Director of Revenue Cycle Management, the Central Billing Representative I is responsible for maintaining a high-performance work environment characterized by positive relationships and a strong orientation towards customer service and timely quality patient billing. The Central Billing Representative I is responsible for direct interaction and assistance to Site Biller Representatives, patients, physicians, colleagues, contractors and consultants for the purpose of billing, collection and reporting of multi-specialty self-pay, third party payer accounts receivable and claims on a daily basis. Review site batched patient encounters for charge and payment accuracy, including encounter rate and other necessary billing adjustments. Monitor and review site unbilled encounters and assist to meet mutual daily and weekly deadlines. Provide education on encounter batches to minimize error recurrence and support maximum reimbursement. Meet all end-of-month closing activities and deadlines. Coordinate electronic patient statements on a monthly basis. Post payments received and reconcile system postings to lockbox and/or EOB totals. Record NSF checks and notify patients of adjusted balances due. Review credit balance reports and prepare refund requests for overpayments. Participate in billing Helpdesk customer support by receiving, responding and documenting all incoming account inquiries related to billing issues. Review assigned outstanding accounts receivable to identify problems with insurance payers; follow up on all assigned payer type accounts to facilitate collection of balances. Review and resolve all EOBs to initiate clean claim resubmission and reimbursement. Edit and submit insurance claims for fee-for-service and prospective payment system reimbursement. Resolve unapplied cash, reconcile cash postings and adjust payment allocations to payer types. Communicate payment terms and establish payment plans for overdue balances; monitor compliance. Evaluate uncollectible accounts and make recommendations concerning write-offs or bad debt status. Complete bad debt processes as directed; document activities in the practice management system and MS Word tools. Initiate and complete account adjustments to fix balances and comply with contractual and sliding scale requirements. Assist and train other staff in registration and billing; assist Site Biller Representatives in their absence. Responsible for all other duties as assigned. Requirements
MINIMUM EDUCATION AND EXPERIENCE High school degree or GED One to three years data entry, billing and claims experience in a healthcare setting or FCCH billing externship; related education may substitute for experience Experience in a multispecialty clinic setting Preferred licenses/certifications Certified Coder (medical and/or dental); Billing Certificate from a certified billing program; Coder/Billing certificates may be substituted with demonstrated knowledge of CPT, ICD-10, and dental coding KNOWLEDGE, SKILLS, AND ABILITIES General knowledge of computerized practice management systems; familiarity with Cerner PWPM, Cerner EHR, and Dentrix preferred Ability to learn billing and collection systems in federally chartered CHC and RHI/UHI programs Effective communication with tact and diplomacy with diverse groups, including staff, providers, and insurers Ability to manage multiple assignments with deadlines; work with others in a team environment Knowledge of HIPAA related to medical, dental, and behavioral health billing High level of accuracy and attention to detail; ability to communicate effectively in writing and orally Ability to respond to sensitive inquiries or complaints; work independently with minimal supervision Proficiency with computers and MS Windows; knowledge of FQHC billing and reimbursement preferred Working knowledge of CPT, Dental ADA, DSM V and ICD-10; knowledge of Medicare and Medicaid guidelines; knowledge of UB04 and HCFA1500 forms Familiarity with compliance programs and willingness to comply with laws and regulations Physical Characteristics/Working Conditions
Able to prioritize and respond to diverse demands; periodic travel within the Albuquerque metropolitan area; standard office environment Physical effort and dexterity: good dexterity for computer use; occasional lifting and carrying related to office duties Machines/Tools: capable of using office machines and personal computers Visual/Hearing/Speaking: able to read monitor outputs and clearly communicate for work and safety Work schedule: primarily Monday–Friday; weekends or evenings may be required to meet deadlines Seniority level
Entry level Employment type
Full-time Job function
Accounting/Auditing and Finance Industries
Law Practice Note: This description includes standard job information and may include legally required EEO statements.
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