The Senior Billing Assistant performs those tasks relative to the cycle of a medical claim in an efficient and accurate manner. Such tasks pertinent to this cycle include, but are not limited to, verification of patient insurance information, billing medical charges, and posting cash payments. Position requires utilization of the center’s electronic practice management system (EPM). In addition to performing duties required of the Billing Assistant, the Senior Billing Assistant is responsible for balancing month end cash, follow-up of unprocessed claims, and follow-up and tracking of denied claims during the appeals process.
- Respect and maintain patient confidentiality in all aspects of care including use of electronic information.
- Treat all patients in a welcoming and professional manner.
- Demonstrate professionalism by appropriate attire, attendance, attitude, and behavior within the clinical setting.
- Contribute to the team effort by supporting all team members and maintaining an open and positive attitude.
- Welcome new employees and students to the team by assisting with their orientation to the team and mentoring them, as requested.
SPECIFIC TASKS AND RESPONSIBILITIES:
- When necessary for billing activities, verify assigned patient treatment coverage and policy information such as effective date, coverage status, addresses, tel. numbers, e-mail addresses, etc. thru those means of communication most effective with either the insurance agency or patient.
- Process assigned medical charges to specific, designated patient claims, which requires a general knowledge of common billing terms and codes used to represent patient treatment. All processing activities performed within health center’s current computer applications.
- Bill assigned patient claims to insurance agencies either by computer or mail. Billing by means of mail will include the production of paper 1500 forms along with copies of any required additional information. Billing by means of computer will include doing so within the computer application at hand, identification and interpretation of claim edits relative to assigned insurances, and providing necessary corrections of claim edits in order to complete timely claim submission.
- Enter correct claim payments, adjustments, and reason codes in order to produce accurate, balanced posting of an assigned payer’s EOB claim data.
- As needed, provide assistance in the processing of patient accounts identified as Workman’s Compensation and/or Auto Accident Insurance.
- File billing information. Such filing will be labeled by payer and dated in order to allow for the appropriate recall of all necessary billing history when deemed appropriate by either LCHC or outside sources.
- Perform tasks and requirements previously listed within the expected time frame allotted per month and referred to as Month End.
Senior Billing Assistant will fulfill the following additional tasks, in addition to those previously listed, also in an accurate and efficient manner.
- Balance receipt of Month End cash within its assigned journal as well as provide explanation of any existing variances.
- Follow-up on assigned payer’s unprocessed claims to achieve completion of claim process within a timely manner. Follow up is performed through those available means of communication to the extent where any/all necessary patient billing resolution is provided in such a manner that allows payers the complete process of claims.
- Appeal of assigned payer processed claims identified as a denial. Such Appeal processes will involve investigation of denial reasoning to the point revealing any/all incorrect denials on behalf of the assigned payer, obtaining all necessary information which identifies and demonstrates this erroneous denial, the resubmission of corrected claims or original claims including proof of correct filing, follow-up, and the tracking of appealed claim status to the point of final claim resolution; payment or adjustment. Resolution includes posting of processed claims in the same manner as original payment/adjustment posting.
- Demonstrates an understanding of customer service principles by successfully completing on-line Customer Service training.
- Utilizes the principles of customer service when interacting with patients/clients, team members and staff from other departments.
- Appropriately handles or seeks support when customer service breakdowns occur.
- Demonstrates knowledge of culture by successfully completing the on-line training on Cultural Competence.
- Utilizes an appreciation of and respect for diversity when interacting with patients/clients, team members and staff from other departments.
- Responds appropriately or seeks support when confronted with cultural biases or conflicts.
- Is aware that in order to respond promptly and appropriately to emergencies, any staff member may be assigned temporary duties that differ from those in the job description, or may be assigned temporarily to a different location or schedule.
- Understands that all staff should have a Personal Emergency Plan in place to best respond to his/her job responsibilities should a health center emergency arise.
- Works under the direction of the Patient Accounts Manager.
- History of good attendance and positive work attitude
- Accurate numerical ability
- Detail orientated
- Up to date immunization and annual TB testing is required.
- Hepatitis B vaccine and annual flu immunization are strongly recommended.
- All necessary vaccines are provided by the health center free of charge.
- Results of inquiry to Criminal Offender Record Investigation (CORI) must be acceptable according to health center standards.
- Ability to meet reasonable deadlines for monthly closing
- 1-2 Years experience related to Medical Billing.
- 1-2 Years experience related to Eye Clinic Billing
Lynn Community Health Center (LCHC) provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, LCHC complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, and transfer, leaves of absence, compensation and training. LCHC expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of LCHC’s employees to perform their job duties may result in discipline up to and including discharge.
Job Posting# 18-115