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Billing Specialist Health Services
Benefits OfferedDental, Life, Vision, Medical
Why work here?
“Every day we change people's lives. For thousands of older adults throughout Southwet Florida, we are a lifeline for vital services.”
PURPOSE OF POSITION: The Health Services Billing Specialist will support the Health Services Business Manager in planning, directing and controlling all aspects of group medical and dental revenue cycle for Sarasota County. Ensures billing is in compliance with all laws, regulations, and payer guidelines.
1. In coordination with supervisor, develops, reviews, and implements billing policies and procedures; recommend changes to policies and procedures to ensure best practices/billing compliance.
2. Manages the daily journal creation and closing process, working with clinic staff to verify daily journal balances to receipts and ultimate deposits. Ensures that the next business days journal is created and utilized. Manages other journal types; works with supervisor to close business months after all balancing and data entry is complete.
3. Working with the Fiscal accounting staff and supervisor to ensure that daily charges and receipts are entered accurately, timely and works to find discrepancies in the balancing process.
4. Primarily responsible for entering all ACH and EFT (non-cash, check or credit card) payments received are entered into Intergy timely, accurately, and balances to the daily EFTS and ACH’s.
5. Perform secondary review of claim audits to ensure coding integrity.
6. Make necessary adjustments to claims with complex coding issues.
7. Produce monthly statements for Medical and Dental patients with past due balances.
8. Contacts insurance companies regarding problem or unpaid claims.
9. Review aging reports and identifies trends in denials and resubmits to insurance company.
10. Run pre-billing report prior to billing transmissions and correct errors. Bill appropriate funding source for services provided, to include Medicare, Medicaid, HMO, Private Pay and Uninsured/County funding sources.
11. Answers patient phone calls regarding billing statements and provide information/education.
12. Ensure charges are processed within acceptable period from the final review by physician.
13. Ensures charges are documented and submitted with accuracy in a timely manner per payor guidelines.
14. Works to keep the health-services accounts receivable aging within industry standards; maximizing patient co-pays and payments, maximizing insurance payments.
15. Keeps abreast of all coding industry updates and changes in billing regulations.
16. Serves as the backup for Financial Eligibility Coordinator position during extended absences.
17. Prepares documentation of patient accounts for charge and/or balance write off or account adjustment.
18. Develop and implement monthly reports, policies and processes to reduce inefficiencies and maximize revenue by improving the medical billing, coding, and collections functions.
19. Responsible for monthly billing of Managed Long Term Care for both Home Delivered Meals and Adult Day Care, and all associated coordinating, monitoring, collections.
20. Responsible for timely, accurate data entry of patient visits into client tracking database.
21. Position is based in Venice, but may require frequent travel between Venice and Sarasota, for which mileage reimbursement is available.
22. Be familiar with Medicare and Medicaid websites, seeking out and educating self and supervisor on upcoming changes.
23. Maintain adequate files, back-up documentation, etc., for review/audits as needed.
24. Performs other related duties as may be assigned.
1. Must comply with all SFC policies and procedures.
2. Works independently to organize work for maximum efficiency and attention to quality.
3. Maintains the highest level of confidentiality in all matters and complies with HIPAA policies and procedures.
4. Must protect the safety and health of the staff and others. Must observe and follow the provision of the SFC Employee Handbook and Department Safety Rules related to accident prevention, safety and reporting of injury, accident and incident policies.
SUPERVISION RECEIVED: Direction is provided by the Health Services Business Manager. Work is performed largely on basis of own judgment and initiative in accordance with established routines and industry compliance. Unusual problems or questions are referred to supervisor for guidance and assistance. Tasks are assigned and work is reviewed and evaluated for timely completion.
SUPERVISION EXERCISED: No direct reports. Communication is routinely conducted with the financial eligibility coordinators, referral coordinators, medical clinical coordinators, credentialing coordinators and front office and clinic leads. This includes paid staff and volunteers assigned to any billing functions.
EDUCATION, EXPERIENCE AND TRAINING: Associates degree in Business, Health Administration or related field preferred. Five (5) years of medical and dental billing and coding experience may substitute for educational requirements. Experience with Vitera Intergy and Athena preferred.
KNOWLEDGE ABILITIES AND SKILLS:
1. Demonstrated knowledge of diagnosis and procedural coding in medical and dental billing practices.
2. Demonstrated competence with analytical skills and problem solving techniques.
3. Ability to provide accurate information, plan and manage multiple tasks and individuals, set own goals, establish priorities and meet ambitious deadlines in a timely manner.
4. Proficiency with EMRs, practice management and health care systems.
5. Experience with health services operations, reimbursement and finance.
6. Excellent verbal, written communication skills
7. Excellent interpersonal, leadership and motivational skills
8. Provide presentations, training and meeting facilitation with a professional image at all times
9. Proficient in Microsoft Word, Excel, Vitera Intergy (preferable), Athena and working knowledge of database management and office equipment.
Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this Job, the employee is regularly required to talk or hear; frequently required to sit, stand, walk and use hands to manipulate, handle, or feel; may occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. Pre-employment substance abuse testing and Level II background check is required.
Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Work environment may vary between locations and include stairs, office space adaptation when traveling, and a moderate noise level.
FDLE Level II Background check, valid Florida Driver’s License and proof of insurance is required for this position. Pre-employment drug and TB screening required.
EOE/DRUG FREE/SMOKE FREE WORKPLACE
About Friendship Centers, Inc.:
Non-profit elder services agency with locations in SW FL. Adult Day Services, Caregiver Resources Centers, Health Services including Medical and Dental, Congregate Dining, Enrighment Classes, Activity Center and Social Services. For locaations and services go to our website: www.friendshipcenters.org.
Posted date: 2 months ago
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