Biller/Scheduler - Flagler Home Care, Full-time days 8:30am-5:00pm Monday through Friday

Flagler Hospital - Saint Augustine, FL3.9

Full-timeEstimated: $44,000 - $56,000 a year
EducationSkills
Job Description Details

Job Title:
Biller/Scheduler

Last Updated:
(MM/DD/YYYY)
11/30/2017
Summary
Comments
The biller/scheduler will be responsible for billing of medical claims (UB04 and CMS 1500 forms)
for reimbursement to various health care payers and scheduling patients. The focus of the billing
is to review the claim for accuracy and completeness prior to billing. Works with clinicians and
patients to obtain complete demographic information and accurately schedule patient visits.
Effectively communicates scheduling information to internal and external customers, while
maintaining a focus on customer service and patient confidentiality. Responsible for managing
patient record from start of services to discharge, to include coding and physician order tracking.
Education / Training
Degree/Diploma Obtained
Program of Study

High School Diploma or Equivalent

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Preferences
Skills and Abilities: Must be familiar with UB04, 1500, ICD-10, CPT, HCPCS and Modifiers.
Previous experience with electronic billing required. Knowledge of Medical Terminology
required. Computer literacy required.
Experience Requirements
Min Experience
Type of Experience
2 years
Hospital or physician office billing/scheduling experience
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Preferences
Preferred: Home health office and/or Home health staffing experience.
Licensing Requirements
Certificates/Licenses/Registration

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Preferences
Preferred: Medical Billing & Coding Certificate
Working Conditions
Condition Type
Frequency
Specifics
Indoor
Constant (66-100% of workday)

High Temperatures
Not Applicable

Loud Noise
Occasional (0-33% of workday)

Confined Areas
Constant (66-100% of workday)

Outdoor
Not Applicable

Cold Temperatures
Not Applicable

Fumes
Not Applicable

Physical Demands
Demand Type
Frequency
Specifics
Standing/Walking
Not Applicable

Sitting
Constant (66-100% of workday)
For long periods of time
Reaching, Twisting
Occasional (0-33% of workday)

Balancing/Climbing
Not Applicable

Stooping/Kneeling
Not Applicable

Driving
Not Applicable

Talking
Occasional (0-33% of workday)

Seeing
Constant (66-100% of workday)

Hearing
Constant (66-100% of workday)

Weight Demands
Demand Type
Frequency
Specifics
1-25 lbs. Lifting, Carrying, Pulling/Pushing
Occasional (0-33% of workday)

25-50 lbs. Lifting, Carrying, Pulling/Pushing
Occasional (0-33% of workday)

50+ lbs. Lifting, Carrying, Pulling/Pushing
Not Applicable

Intellectual Demands
Demand Type
Frequency
Specifics
Problem Solving
Constant (66-100% of workday)

Supervise
Not Applicable

Organize
Occasional (0-33% of workday)

Plan
Occasional (0-33% of workday)

Decision Making
Occasional (0-33% of workday)

Interpret Data
Constant (66-100% of workday)

Write
Occasional (0-33% of workday)

Reading
Constant (66-100% of workday)

Equipment Use
Equipment Type
Frequency
Specifics
Telephone
Occasional (0-33% of workday)

Computer (Beginner Level)
Constant (66-100% of workday)

Computer (Intermediate Level)
Constant (66-100% of workday)

Computer (Advanced Level)
Constant (66-100% of workday)

Copier/Fax
Occasional (0-33% of workday)

Patient Testing Equipment
Not Applicable

Patient Transport Equipment
Not Applicable

Occupational Exposure

Occupational Exposure
Category III = Job involves tasks or procedures that have no exposure to blood and other potentially infectious materials during the performance of duties.
Essential Responsibilities

Responsible for efficient, expedient and accurate patient scheduling; requests an accurate clinical history as necessary for the appointment; provides instructions, and specific preparations to the individual scheduling the appointment; reviews and evaluates scheduled appointments for completeness and compliance with applicable regulatory guidelines and agency policy.

Processes the majority of home health agency related claims electronically. Will also be required to submit certain claims manually per provider. Ensures timely submission to the carrier for maximum reimbursement.

Reads, maintains and implements all billing and compliance updates from Medicare, Medicaid, Commercial, and Private Payors.

Accountable for reviewing, researching and resolving all billing issues in agency EHR/billing software prior to claim submission in order to minimize denials.

Obtains managed care authorizations as appropriate.

Responsible for diagnosis coding. This may include query to physician or other provider to obtain accurate and clinically supported information.

Core Competencies

Safety
Makes sure to understand every safety practice expected by the organization. Takes no shortcuts that increase the risks of accidents, personal injuries or equipment failures. Looks for unsafe practices in the workplace and takes responsibility to ensure that others are aware of the potential impact. This is distinctly different from those who are unaware of many safety expectations, take shortcuts that increase safety risks, and/or fail to recognize and take timely action to increase safe practices by others.
Quality of Work
Has established a track record of producing work that is highly accurate, demonstrates attention to detail and reflects well on the organization. Is personally committed to high quality work and encourages others to have similar standards. This differs from those who cannot be relied upon to produce high quality work, pay little attention to detail, show little pride in a job well done and/or set a poor example for co-workers or direct reports.
Teamwork
Is an effective team player who adds complementary skills and contributes valuable ideas, opinions and feedback. Communicates in an open and candid manner and can be counted upon to fulfill any commitments made to others on the team. This is distinctly different from those who withhold ideas and opinions, offer ideas or opinions that rarely add value to team discussions, have established a track record with many unmet commitments, and/or have not contributed skills that complement the skills of others on the team.
Continuous Improvement
Finds it unacceptable when patient and customer outcomes could be improved. Takes personal responsibility for maintaining and upgrading own knowledge, skills and abilities to ensure that service delivery is safe, efficient and effective. Strives to stay abreast of new approaches to healthcare. Demonstrates full commitment to quality improvement initiatives by taking an active role, being a positive model and by encouraging others to be equally committed and accountable. Is proactive in calling attention to service delivery deficiencies or opportunities and offers concrete suggestions for improving processes and systems that affect quality of care and productivity.
Education and Self Development
Makes it a practice to take charge of self-development by soliciting feedback, setting priorities, and then acquiring or strengthening skills and knowledge through coursework or other methods. This is in distinct contrast to those who avoid, discount or ignore feedback, fail to identify self-improvement needs or resist learning opportunities as unnecessary or untimely.
Commitment to Accountabilities
At Flagler Hospital, certain values shape and influence all of our decisions and actions. These accountabilities are demonstrated through adherence to our core competencies and represented each day in our commitment to patients and their families, visitors, and our team members.
Employee Statement of Understanding
The above statements reflect the responsibilities considered essential to the job as identified and shall not be considered a detailed description of all the work requirements inherent to the job. I agree to perform other job duties as assigned.

I have read and understand the job description for my position. I am able to perform all of the essential functions of this position.

As an employee, I will strive to uphold the mission and vision of the Flagler Hospital. All employees are required to adhere to the values in all their interactions with patients, customers, and fellow employees.