Full Time

Department: BH Internal Medicine Clinic

Shift:  Day

Working Hours:  8:00am to 5:00pm

This job will be authorized 80.00 hours bi-weekly.

Requirements:

• HS Diploma and/or GED Equivalent
• Medical Billing and ICD-9 and CPT coding experience preferred.
• Must be computer literate.
• Excellent customer service/interpersonal communication skills.
• Detail oriented.

Responsibilities/Duties:

• Provides training and/or assistance to co-workers in regards to departmental procedures as directed by manager.
• Answers department specific technical questions.
• Troubleshoots problem areas and provides feasible solution to manager for review.
• Maintains and ensures compliance with all departmental policies and procedures.
• Processes insurance billing promptly and accurately to ensure collectability.
• Actively reviews existing patient data and status of account balances to insure correct and accurate billing.
• Processes daily posting information, monitors statement procedures as applicable to clinic, requests refunds and forwards to appropriate person and maintain any other actions required for proper account maintenance according to policy.
• Prepares account for secondary insurance filling, if applicable, or transfers account to patient responsibility according to policy.
• Routinely investigates insurance denials and takes appropriate action to ensure payment of claim
• Per allotted time as approved by individual clinic manager, employee will review A/R and take appropriate steps to facilitate collections according to policy.
• Maintains accurate record of postings if applicable (i.e., EOB’s, copies of patient checks and/or check stubs, posting logs, etc.) for future reference as needed.
• Posts all A/R payments and/or adjustments in a timely manner as applicable to individual clinic.
• Generates claim forms and attaches all necessary documentation or EOB’s required for maximum payment; notifies Supervisor of any unusual occurrences regarding formatting and/or entry issues found upon close inspection of the claims prior to mailing.
• Provides insurance companies with additional information or documentation needed for claims appeal or payment processing.
• Provides patient with copies of statements as needed (i.e., personal, tax purposes, insurance purposes, etc.).
• Provides WC carriers, Attorney’s and other professional entities with needed information for payment of claims.
• Researches credit balances and processes refunds or transfers to the appropriate party on a weekly basis or according to clinic/department specific guidelines. Includes working unapplied and overpaid line item reports. Submits refunds/transfers with supporting documentation in the proper order for A/P processing to Supervisor.
• Keys charges timely and accurately. Checks coding, waivers, modifiers to ensure clean claim submission. Scrubs claims and works errors appropriately.
• If applicable, researches account credit balances to determine source of payment and necessity of refund. Submits refund requests with appropriate documentation to Practice Plus Accounts Payable in a timely manner.
• Posts all receipts from patients in a timely manner. If applicable, posts insurance payments, differentiates between contractual and non-contractual adjustments and applies appropriate write-offs to patient's account. Transfers responsibility to appropriate patient, secondary or tertiary party, making any necessary comments on patient's account for clarification.
• If applicable, investigates insurance denials in a timely manner and takes appropriate action to ensure payment. Reports unusual denials or patterns to supervisor.
• Routinely reviews accounts receivable and takes appropriate steps to facilitate collections. Reports accounts to collection agency with appropriate documentation after receiving authorization. Communicates on a regular basis with collection agency concerning forwarded accounts.
• Identifies, works and reports coding errors to supervisor as appropriate.
• Performs insurance billing, both electronic and paper, in a timely manner and verifies claim information to ensure proper collection. Also conducts necessary pre-certifications, if applicable.
• Coordinates day-to-day functions within an individual area and/or department to ensure that all processes are running efficiently and effectively.

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Today, Baptist Health is Arkansas’ most comprehensive healthcare organization with more than 250 points of access that include 11 hospitals, urgent care centers, a senior living community, and over 100 primary and specialty care clinics in Arkansas and eastern Oklahoma.
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