Position Summary:

Performs a variety of complex clerical and accounting functions for patient billing, including maintenance of billing records and the resolution of a variety of claims issues.

Internal and External Contacts:

Patients, families, co-workers, visitors, vendors, insurance companies.

Duties and Responsibilities:

• Reviews all claims for completeness and accuracy and makes the necessary corrections.
• Stays current on all billing guidelines.
• Researches and responds by telephone and in writing to patient inquiries regarding billing issues and problems.
• Follows up on submitted claims; monitors unpaid claims; resubmits claims as necessary.
• Keeps supervisor informed of problems or potential problems.
• Works and keep tracks of cases in Athena regarding issues directly related to claim submission, formatting and payment posting.
• Assist co-workers with problems, issues or complaints.
• Works PROREVIEW worklist (prompt pay)
• Posts payments from unapplied.
• Performs direct contact with Athena Customer Success Manager on any unresolved billing and/or payment issues.
• Works directly with insurance representatives to discuss and resolve denial trends or problems with our payments or contracts.
• Completes Bad Debt review monthly.
• Completes other duties as assigned by supervisor.
• Assists with other special projects as assigned by management, such as:
• Processing credit card payments from insurance companies
• Completing retroactive sliding fee claims
• Applying patient payments to accounts
• Assisting with specialty billing, such as dental
• Compiling reports for CFO, Controller and Revenue Cycle Manager
• Tracking provider errors to ensure accurate charting

Qualifications:

• High School Diploma

• 2 or 4 year degree in a related field or a minimum of two years Billing/Coding experience required.
• An equivalent combination of education and/or work experience will be considered.
• Certified Professional Coder (CPC) certification required.
• FQHC billing experience preferred.

Knowledge, Skills Abilities:

• Excellent written and verbal communication skills required.
• Excellent telephone etiquette.
• Demonstrated ability to prioritize multiple tasks, assignments and projects to meet established quality and time requirements.
• Demonstrated ability to navigate the internet, including usage of and the ability to successfully and accurately utilize web-based programs and applications.
• Able to relate to a variety of people at different developmental levels.
• Able to prioritize tasks and manage time efficiently.
• Flexible as to the changing needs of the Center.
• Able to use independent judgment and to manage and impact confidential information.
• Demonstrates cooperative co-worker and community relationships by being friendly, polite, helpful, and non-critical or judgmental of others.
• Demonstrates knowledge of safety procedures as well as the management of information as it relates to privacy, confidentiality and HIPAA.

To learn more about Tandem Health and our benefits, please click the links below.

https://tandemhealthsc.e3applicants.com/about-us/benefits-trial

https://www.youtube.com/watch?v=STg1IbibH5g