Billing Specialist - Lab AdminGeneral in Santa Fe, NM

Summary:

Responsible for the complete charge capture process for the CSVMG clinics in its entirety. Includes gathering necessary reports linked with a distinct date of service. Daily collection, reconciliation and organization of service charges from each provider to ensure .all services rendered by CSVMG providers and locum providers are captured. Coordinate and communicate effectively and efficiently with the practice managers and CSVMG providers to ensure receipt of all charge capture data. Scan all documents associated with appropriate date of service Into the EMR system to provide ease of access to the providers, managers, and coders. Will assist in charge entry into the billing system/EMR when necessary for backup.

Responsibilities:

• Answers phone in a pleasant manner and is always respectful. Identifies him or herself with a name and title and location.
• Gathers accurate data from practice management systems to ensure Coding Specialists or outside coding agency receives all documentation to accurately code.
• Collection of all charge card/sheet from all CSVCG and Locum providers in an organized, effective and timely manner.
• Enters all information gathered from hospital systems into the clinic practice management system efficient and effectively.
• Obtains authorization and demographic information from hospital’s system registration as needed for all hospital services rendered by CSVCG providers.
• Applies knowledge of state/federal regulations related to health claims processes and ensures compliance.
• Maintains ongoing knowledge of the insurance industry rules in order to ensure accurate entry of all insurance information.
• Ensures necessary reports are maintained and distributed biweekly to the clinic managers and coding specialists or any outside coding agency regarding missing encounters.
• Verifies all patient data and insurance coverage through the use of available electronic software, or any other system to ensure proper collection both on the front end and through the business office.
• Navigates through CSV software system to ensure information on hospital patients is accurate for proper collection follow-up.
• Scans all documents associated with a particular date of service into the EMR system for Coding Specialists and any outside coding agency to code.
• Adheres to all HIPA and other regulatory commission guidelines.
• Will assist as a backup for charge entry functions into the CSVCG billing system.

Requirements:

Education: 

• High School diploma or equivalent required.

Certification/Licenses:  

• N/A

Skills:

• Proficient reading and writing of English
• Current knowledge and experience in medical terminology and approved abbreviations to interpret and assist In the extrapolation of data acquired from operative reports, pathology/cytology reports, history and physicals examination reports, consultations, discharge summaries, and office dictation that is needed for billing
• Establish contact and communication with outside coding agency regularly
• Efficient use and navigation of the computer software systems utilized with the clinics and the hospital
• Knowledge of windows based electronic practice management systems for scheduling, communicating, tasking and scanning
• Accurate knowledge base of all service lines Including hospital inpatient and outpatient services and clinic services
• Comprehends the process in obtaining prior authorizations and the purpose of the prior authorization authentication gathered
• Required to read and understand the multiplicity of insurance cards
• Complete understanding of the verification process set forth by the CSV Clinician Group Policies
• Competent in reconciliation process and necessary investigation to ensure all charges are captured for services provided
• Prepares reports necessary to capture qualitative data
• Ensures the appropriate charges are submitted to certified coders and documentation is sufficient in hospital EMR and when necessary Clinician Group EMR
• Knowledge of general office equipment operation
• Above average verbal and written communication skills to promote service excellence
• Ability to work in stressful situations and perform multiple tasks simultaneously
• Must be able to work independently
• Must have excellent communication skills.

Experience: 

• Three years of experience in registration and/or front desk operations within a clinic setting or medical environment equivalent preferred. Medical terminology preferred. Three years of experience with computer software used in a medical setting preferred.

Work Schedule:

5 Days - 8 Hours

Work Type:

Full Time