Under direct supervision, performs all collection functions on account balances within assigned financial classes
Education
Specialized training in coding/abstracting procedures, anatomy and physiology and medical terminology obtained through seminars and college courses
Experience
One year of direct billing or collections experience required in a healthcare or insurance environment. Completion of medical billing and coding course and coding certification required. 1 year of CPT and ICD10 coding experience
Knowledge, Skills and Abilities
Knowledge of collection procedures, laws, rules and regulations
Skill in written and oral communications
Skill in performing arithmetic calculations
Licensures, Certifications
Active AAPC certification required
Additional coding certifications applicable to physician practice billing preferred
Principal Duties and Responsibilities
Works with front-desk staff and practice managers to ensure accurate patient registration in the practice management system
Reviews provider documentation for auditing purposes related to billing and communicates with providers when there are errors, missing information, or other inaccuracies
Reviews physician charges, adds modifiers, diagnoses, or other standard coding conventions to ensure accurate and timely billing, making corrections as necessary.
Creates and submits clean claims for billing by reviewing and correcting claim errors in accordance with established policies and procedures
Stays up to date on payer billing requirements, as well as CMS, CPT, and AMA regulations
Reviews and works open encounter, encounter missing charges, and inpatient note reconciliation reports
Communicates with patients when there are questions related to their billing and coding
Functions as the practice liaison with the Billing Office and assists in educating the practice staff about efficient and compliant billing and registration practices
Works with AR staff to resolve/appeal denials
Works closely with Providers, offering assistance and education regarding correct CPT and ICD 10 coding as well as documentation requirements
Manages time effectively and reviews a minimum of 12 charges sessions an hour
Maintains coding certification through continuing education courses
Physical Requirements
Working Conditions
Conditions of Employment
N/A
All roles must demonstrate GBMC Values
Respect
I will treat everyone with courtesy. I will foster a healing environment.
Treats others with fairness, kindness, and respect for personal dignity and privacy
Listens and responds appropriately to others’ needs, feelings, and capabilities
Excellence
I will strive for superior performance in every aspect of my work. I will recognize and celebrate the accomplishments of others.
Meets and/or exceeds customer expectations
Actively pursues learning and self-development
Pays attention to detail; follows through
Accountability
I will be professional in the way I act, look and speak. I will take ownership to solve problems.
Sets a positive, professional example for others
Takes ownership of problems and does what is needed to solve them
Appropriately plans and utilizes required resources for various job duties
Reports to work regularly and on time
Teamwork
I will be engaged and collaborative. I will keep people informed.
Works cooperatively and collaboratively with others for the success of the team
Addresses and resolves conflict in a positive way
Seeks out the ideas of others to reach the best solutions
Acknowledges and celebrates the contribution of others
Ethical Behavior
I will always act with honesty and integrity. I will protect the patient.
Demonstrates honesty, integrity and good judgment
Respects the cultural, psychosocial, and spiritual needs of patients/families/coworkers
Results
I will set goals and measure outcomes that support organizational goals. I will give and accept help to achieve goals.
Embraces change and improvement in the work environment
Continuously seeks to improve the quality of products/services
Displays flexibility in dealing with new situations or obstacles
Achieves results on time by focusing on priorities and manages time efficiently
Pay Range
$24.84 - $40.72
Final salary offer will be based on the candidate's qualifications, education, experience and alignment with our organizational needs.
Equal Employment Opportunity
GBMC HealthCare and its affiliates are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.
