Central Billing Representative I
On-siteAlbuquerque, New Mexico, United States
Job Summary
Review site batched patient encounters for charge accuracy and monitor unbilled encounters to meet daily and weekly deadlines. Post payments, reconcile system postings to lockbox and EOB totals, and record NSF checks. Provide education on encounter batches to minimize errors and support maximum reimbursement. Participate in billing Helpdesk support by responding to incoming account inquiries via electronic, telephone, and written channels. Resolve outstanding accounts receivable by following up on payer issues, editing and submitting insurance claims, and initiating clean claim resubmissions. Coordinate electronic patient statements monthly and communicate payment plans for overdue balances. Document all activities in the practice management system and assist other staff members as requested.
Required Qualifications
- High school degree or GED
- One to three years data entry and billing and claims experience in healthcare setting or FCCH billing externship
- Experience in a multispecialty clinic setting
- Ability to learn billing and collection system within federally chartered community health centers (CHC) and RHI/UHI programs
- Ability to communicate with tact and diplomacy with diverse groups of people including staff, providers, and insurance companies on behalf of the organization
- Ability to display sensitivity to the patient population being served
- Ability to work on a variety of assignments concurrently within established deadlines
- Ability to work with others in a problem solving and team environment and to work alongside staff as needed
- Knowledge of HIPAA as it relates to medical, dental & behavioral health billing
- Position requires a high level of accuracy and attention to detail
- Ability to communicate effectively, both orally and in writing
- Ability to respond effectively to sensitive inquiries or complaints
- Ability to work independently with minimal supervision
- Proficient with computers and MS Windows software programs
- Knowledge of Medicare and Medicaid guidelines
- General knowledge of UB04, HCFA1500 and Dental ADA Electronic and Paper claim forms
- Knowledge and familiarity with compliance program
- Position requires travel throughout the Albuquerque metropolitan area
- Work regularly scheduled Monday-Friday, although weekends and evenings may be required to meet with members of the Board of Directors and meet deadlines
Desired Qualifications
- Certified Coder (medical and/or dental)
- Billing Certificate, the result of graduation from a certified billing school
- Coder and/or Billing Certificate may be substituted with demonstrated proficient knowledge of procedural CPT & Dental Coding and/or ICD-10 diagnosis coding
- General knowledge of computerized practice management systems, preferably Cerner PWPM Practice Management System, Cerner Electronic Health Record System and Dentrix Dental billing and E H R
- Knowledge of Federally Qualified Health Care billing and reimbursement preferred
- Working knowledge of CPT, Dental ADA, DSM V and ICD-10 preferred
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