NEW OP Template (PR & TLM MME / HR Enterprise) - Pay Calc 2.0
Billing Control Clerk (Administrative)
Works with other billing staff in initiate billing of claims, rebill as necessary, appeal denials, and modify payers as necessary, file paper claims, follow-up on accounts until zero balance or turned over for collection.
Review statements organized by alphabet. Task encounters for Bad Debt and Write -off.
Manual charge entry of paper fee tickets, i.e. Family Pact, CDP, hospital, and home visits.
Utilize EHR documentation to ensure accurate charge and code entry in case of conflict (denial).
Accurate posting of payments and denial adjustments received from third parties and patients.
Utilize Medicare FISS system to follow up Medicare denied claims.
Follow up on credit balance and unapplied credit reports.
Requests adjustments to accounts based on organizational guidelines.
Maintains required billing records, reports, files.
Assist with front office error resolution, including completion of assigned tasks.
Tutor Front office on error correction and work flow management.
Assist with telephone inquiries and provides information requested.
Periodic feedback to Billing Manager and Revenue Cycle Manager.
Backup for electronic claims submission.
Scan explanation of benefits into system for reference.
Monthly reporting to Billing Manager of status of assigned accounts older than 90 days based on A/R aging reports and participates in educational activities.
Maintains strictest confidentiality.
KNOWLEDGE, SKILLS AND ABILITIES
Ability to work without direct supervision.
Ability to take directions and meet deadlines in a timely manner
Knowledge of medical terminology, including CPT and ICD 10, and clinic systems
Current Knowledge of medical billing, accounting procedures and applications, particularly as they relate to FQHC operations. And Encounter Rate Billing
Knowledge of claims review, analysis, and quality assurance.
Basic working knowledge of Microsoft Office, including Outlook, Excel, and Teams.
Knowledge of commercial insurance and government reimbursement programs.
Possess good verbal and written communication skills.
Multi-task oriented with attention to detail.
EDUCATION AND EXPERIENCE REQUIREMENTS
High school graduate or equivalent.
10 key by touch, type 45 wpm.
Three years' experience using computer application software.
Minimum 2 years related experience, preferably with NextGen Program.
BENEFITS
Competitive Wages
Medical Insurance
Dental Insurance
Vision Insurance
403 (b) Retirement Plan with matching employer contribution
Long-term Disability coverage
Accidental Death and Dismemberment
Life Insurance
Flexible Spending Account
Paid Vacation
Paid Holidays
CME with stipend
Employee Assistance Program
Jury Duty Pay
Bereavement Pay
Health Club Membership Discounts
Prescription Discount Program
529 College Savings Plan
Educational Reimbursement
Free subscription based App for Meditation and Sleep
Free Teledoc service for benefit eligible employees