Compensation Overview

POSITION SUMMARY:

• Maintains database by entering payment information into database ( adjustments and denials)
• Back-up for generating daily POB extractions
• Assist with external and internal audits 
• Reconcile cash batch supporting department cash control policies and procedures
• Assist with new hire training and refresher training
• Maintain and update SOP’s and job aides
• Complete batch posting with 98% accuracy
• Identify incomplete information necessary to post remittance, contact Manager to resolve questions, inconsistencies or missing data
• Assure 100% accuracy with regards to content and spelling.
• Requires outreach to customers/clinics to validate incomplete information
• Prepares source data for computer entry by compiling and sorting information; establishing entry priorities
• Contacts patient/clinic directly to validate incomplete information
• Maintains operations by following policies and procedures; reporting needed changes
• Maintains customer confidence and protects operations by keeping information confidential
• Contributes to team effort by accomplishing related results as needed
• Works on various databases (EP) error processing reports; as needed
• Ability to maintain department metrics (daily, weekly & monthly)

PRIMARY RESPONSIBILITIES:

• Review and interpret explanation of benefits (EOB) from insurance carriers to post appropriate payment and denial codes.
• Enter alphabetic, numeric or symbolic data such as denial codes into system, following the format displayed on screen.
• Reconcile cash batch supporting department cash control policies and procedures.
• Complete batch posting with 98% accuracy
• Identify incomplete information necessary to post remittance, contact Manager to resolve questions, inconsistencies or missing data.
• Learn computer applications as they relate to denial management systems; proficiency in a practice management system.
• Organization, Attention to Detail, Confidentiality, Thoroughness, Decision Making, Independence, Analyzing, Information, Results Driven.
• Open to feed-back
• Other duties as assigned by Management.
• This role works with PHI on a regular basis both in paper and electronic form and have an access to various technologies to access PHI (paper and electronic) in order to perform the job
• Employee must complete training relating to HIPAA/PHI privacy, General Policies and procedure Compliance training and security training as soon as possible but not later than the first 30 days of hire.
• Must maintain a current status on Natera training requirements.

​QUALIFICATIONS:

• 1 year  of Accounting experience
• Required- High School Diploma- GED
• Preferred Bachelor’s degree, or equivalent in Healthcare, Marketing, or Business related field
• 2 + years’ experience in healthcare insurance billing, knowledge of third party insurance in regards to plan types (HMO/PPO/POS and Indemnity)

KNOWLEDGE, SKILLS, AND ABILITIES:

• Strong data entry skills; ability to input a high volume of information
• Proficient 10 key skills; subject to testing
• Medical terminology preferred
• Knowledge of CPT, ICD-9 and ICD-10; medical terminology
• Excellent phone communication skills
• Organization
• Attention to Detail
• Confidentiality
• Thoroughness
• Decision Making
• Independence
• Analyzing Information
• Results Driven