Medical Billing Specialist

at Community Council of Idaho in Idaho Falls, Idaho, United States

Job Description

Status: Non-Exempt / HOURLY          Regular Full Time        Reports to: Clinic Administrator

Essential Duties and Responsibilities (This is not an exhaustive list of all duties/responsibilities. Other duties may be assigned)

• Verify that claims are submitted with zero errors
• Prepare claims for mailing when necessary
• Timely follow up on insurance claim denials, exceptions or exclusions
• Verify completeness and accuracy of coding prior to submission to Athena
• Monitor and post as needed, payments received from insurance, Medicare, Medicaid, patients, etc. daily to ensure proper credit and accounting
• Utilize monthly aging A/R reports to follow up on unpaid claims aged over 30 days
• Perform A/R audits
• Maintain A/R filing system
• Respond to inquiries from insurance companies, patients and providers regarding coding and billing
• Oversee the operations of the billing department
• Read and interpret insurance Explanation of Benefits (EOB)
• Keep track of P&P patients, create the monthly invoice to submit in a timely manner
• Check Quest Lab monthly invoice for patient payments, if payments not received enter charges
• Timely communication to the Officer Manager regarding trends with payors/front desk and other issues that are potentially disruptive to cash flow
• Review credit balances and act in a timely fashion
• Verify patient statements have been sent out timely
• Ensure aged patient balances, over 90 days, are reviewed and sent to collections as needed
• Follow up with collection agency as needed
• Follow-up on any missing claims/billing
• Collect provider/patient information for appeals
• Run operational/financial and quarterly Medicare reports
• Negotiate and monitor payer contracts
• Oversee refunds and credit balances
• Handle any payment arrangements
• Assist with Provider credentialing
• Work in collaboration with Accounting on pertinent issues affecting revenue
• Review records to ensure proper coding based on guidelines and conventions
• Ability to multi-task, manage time, meet deadlines and remain calm and professional under pressure
• Establish and maintain effective working relationships with staff, patients, organizations, insurances
• Remain current on trends/changes in the laws and regulations governing medical record coding, and documentation
• Maintain standards of confidentiality of CC Idaho clients and records
• Maintain strict confidentiality and compliance with HIPAA standards and other grant requirements
• Perform all work duties and activities in compliance with CC Idaho, Joint Commission, OSHA and HIPAA regulations

Qualifications                                                

Required

• High School Diploma or GED
• One-year experience in medical billing
• Working knowledge of CPT and ICD10 codes and medical terminology
• Current driver's license and proof of auto insurance
• Must pass a background check
• Ability to operate standard office equipment and be proficient in Microsoft Office applications
• Evidence of no communicable disease

Preferred

• Certified Professional Coder (CPC) certification
• Ability to read, speak, and write in both English/Spanish in a business setting

Required Physical Demands

• Is frequently required to stand; walk; climb or balance, sit, stoop, kneel, crouch, or crawl; reach with hands and arms
• Frequently communicate by talking/hearing
• Must be able to lift and/or move up to 20 pounds

BENEFITS

“CCI is a strong, non-profit agency to work with. They respect work-life balance and allow for flexibility when it is needed. Excellent premiums on benefits packages. Good working environment with opportunities for advancement."

For detail Benefit plan please visit:                 https://communitycouncilofidaho.org/apply-today/

Health Benefits

• Medical benefits
• Dental benefits
• Vision benefits

Financial Well-Being

• Basic Life Insurance with Accidental death & dismemberment
• Supplemental Voluntary Life
• Long- and Short-Term Disability
• Flexible Spending Accounts (Medical & Dependent Care)
• 401K
• Voluntary Benefit Options
• Accident Insurance
• Critical Illness
• Legal Ease
• Norton Life Lock

Work/Life Balance (Regular Full Time)

• Generous Paid Time Off Policy (PTO)
  • First year of service – 20 days
  • After five years of service – 25 days
  • After ten years of service – 30 days
  • After twenty years of service – 35 days
  • After thirty years of service – 40 days
• Twelve Paid Holidays
• Employee Assistance Program (EAP)
  • 10 free sessions per each topic/situation
  • Assists employees with personal problems and/or work-related problems that may impact their job performance, health, mental and emotional well-being

Educational leave

Up to 5 hours per week to utilize towards education, upon approval and eligibility