People's Health Centers | St. Louis, MO | Full Time
Summary: Responsible for billing activities in accordance with PHC policies and procedures.
Essential Duties and Responsibilities: include the following. Other duties may be assigned.
Responsible for claims submission and assuring the quality control measures are in place. Prepares all the statements for mailing, as measured by the accuracy of the remittances.
Responsible for resolving patient billing problems and unpaid claims with the insurance company, as observed by the Billing Manager.
Responsible for maintaining the Worklog tasks as assigned by NextGen RCM services which include charge corrections/voids.
Correct, edit, and manage denied claims via work log manager: invalid CPT, invalid ICD-9; missing modifier, bill another carrier, invalid eligibility, authorization/referral, documentation required or other work log tasking requiring Practice intervention.
Process refund requests to patients and third party carriers once identified.
Provide phone support for billing inquiries from patients.
Maintain a working knowledge of the current policies and changes in the various insurance and managed care plans.
Maintain a working knowledge of People’s Health Centers grant agreements and contracts and how they affect the patients.
File and store remittance advice(s) according to the finance department’s standards.
Address concerns of patients/organization in a professional manner.
Attends staff meetings/seminars and workshops as needed.
Responsible for other duties as assigned.
This job has no supervisory responsibilities.
To perform the job successfully, an individual should demonstrate the following competencies:
Analytical - Collects and researches data; Uses intuition and experience to complement data; Designs work flows and procedures.
Design - Translates concepts and information into images; Demonstrates attention to detail.
Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics.