Medical Biller/ Office Assistant - Holdrege, United States - RuralMED

Description

Title: Medical Biller / Office Assistant

Department: Revenue Cycle Resources

Status: Part-Time

Location: Hastings, NE

Hello, We Are ruralMED

Join our mission of supporting rural healthcare through collaboration focused on strategically tailored services, effective leadership, and industry-specific expertise.

When you join our team as our Office Assistant, you will play a vital role in supporting our team and the patients for various clinics. You will be responsible for medical billing, answering incoming calls, providing answers to questions pertaining to medical billing and statements, processing customer payments, managing incoming and outgoing mail, posting check payments, preparing deposits, and utilizing a variety of software to ensure patients are being supported for their healthcare and our clinics are receiving maximum reimbursement for the important services they provide.

How This Role Makes an Impact:

• Utilizing your knowledge and skill set, you will experience the rewarding satisfaction of supporting patients and rural healthcare facilities to thrive within the evolving healthcare landscape.
• You will work alongside a team of dedicated and driven experts who are passionate in supporting each other in being the best at supporting rural healthcare.
• Applying your communication, problem-solving, adaptation, and critical thinking skills, you will be empowered to take ownership and to think outside of the box to develop processes and workflows that continue to further enhance our efficacy and accuracy.
• You will play a direct role in being a "Rev Cycle Hero" by ensuring facilities achieve accurate and compliant billing and allowing them to continue to provide their highest quality of care to their patients and communities.

What It's Like Working at ruralMED:

• Our elite and highly-skilled team is driven by delivering top-notch results and supporting each other to reach a new level of excellence to make an impact for our clients and rural healthcare.
• Discover flexibility and autonomy with a company that understands the true value and benefits of work-life balance.
• Personal and professional growth opportunities are encouraged, and employee engagement is not just a measurement, it is a valuable tool to achieving brilliance.
• Our core values are not only motivational, but they are also the standard for how we conduct and take pride in our work.
• It Begins With You: Own it.
• Pave the Way. Never Settle.
• Be Thoughtful. Be Transparent. Be Extraordinary.
• Work Fearlessly. Celebrate the Wins.
• Capitalize Our Strengths. Achieve Excellence.
• Learn more about our team:

How to Succeed in this Role:

• Excellent Critical Thinking, Problem-Solving, and Adaptation skills.
• Ability to take direction and work independently.
• Effective communication and collaboration skills.
• Possess knowledge of medical terminology and/or insurance terminology.
• Ability to quickly pick up new technologies and processes.
• Thrive in a fast-paced atmosphere and be able to flex and adjust to the highest priorities.
• Character Traits: Solution-Based, Highly Motivated, High-Energy, Achiever, Positive, Genuine, Driven, Self-Discipline, Knowledge-Seeking, Responsible.

Stand Out and Get Bonus Points

• Have the knowledge and skills to speak multiple languages (Spanish preferred)
• Possess advanced skills and talents with one or more Microsoft Office programs.
• Innate ability to quickly pick up and learn new technology systems and platforms.

POSITION SUMMARY:

The Revenue Cycle Specialist will be responsible for answering incoming calls for a variety of clinics, answering questions pertaining to medical billing and statements, and processing customer payments. Perform accurate/efficient data entry. Open and distribute mail. Post check payments and prepare deposits for multiple clinics, using a variety of software, and balancing journals and/or batches. Prepare outgoing mail. Perform other office duties as assigned. Compliance with rules and regulations of all applicable federal, state and local laws as well as ruralMED policies is a condition of employment.

QUALIFICATIONS:

• High School Diploma is required.
• Associates degree preferred.
• One to three years' experience in billing, follow-up, or registration within a hospital or clinic setting is preferred
• Knowledge of medical terminology and/or insurance terminology is preferred.
• Proficient with Microsoft Office

General Requirements/Job Duties:

To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Typical functions of this position may include:

Customer Service:

• Answers incoming calls and responds or directs call to the appropriate staff.

Charge Entry:

• Receive and review charge entry data from practice sites.
• Identify and investigate incomplete or missing charges.

Billing:

• Manages and maintains assigned account inventory, completes required reports, and resolves high priority and aged inventory in a timely manner.
• Processes electronic and paper claims in a timely and accurate manner. Ensures edits to electronic claims meet and satisfy billing compliance guidelines for electronic submission.
• Resolves clearinghouse and payer rejections daily.
• Verifies claims adjudication by utilizing appropriate resources and applications.
• Performs immediate follow-up on underpaid or unpaid insurance claims. Researches, identifies and rectifies any circumstances affecting delayed payment of accounts and takes steps to get claim paid utilizing websites, phone calls to the payers, and/or internal inquiry.
• Resolves issues holding up timely claim payment, including requests for medical records, coordination of benefit issues, or requests for other information, by coordinating with the responsible department.
• Resolves denied claims utilizing the payer's designated reconsideration and appeal processes.
• Reviews remaining balances on accounts after insurance has paid to ensure the account was processed appropriately and performs the next appropriate action.
• Resolves overpaid accounts by performing payment review to determine if posting corrections are required or/and a refund is due to the insurance company.
• Processes incoming correspondence from insurance companies and performs proper action utilizing internal and external resources.
• Maintains an account aging process for tracking accounts approaching 30 days past billing date.
• Processes adjustments or corrections to patient account(s) according to policy guidelines.
• Receives and resolves inquiries regarding accounts, either in-person, by phone or written correspondence from patients, family members, third-party payers, physicians, etc
• Accurately and thoroughly documents all actions performed on an account in the appropriate area of the EHR system.
• Initiates telephone or letter contact to patients to obtain additional information as needed.
• Communicates issues to management, including payer, system, or escalated account issues. Identifies denial trends and provide suggestions for resolution.

Self-Pay:

• Reduces outstanding self-pay accounts receivable by following self-pay policies and procedures to increase cash collections and reduce bad debt.
• Make calls to the guarantor/financially responsible parties to follow-up on unpaid self-pay balances.
• Obtains updated demographic and/or insurance information and verifies new insurance coverage prior to rebilling charges.
• Accurately and clearly document all interactions with patients or insurance representatives.
• Assigns accounts to appropriate third-party bad debt collections vendor once internal efforts have been exhausted.

Cash Posting:

• Post payments and adjustments to patient accounts from all insurance payers as well as patient payments.
• Import all electronic payment files into current billing system from multiple sources.
• Review all remittance advices for accuracy to identify errors or questionable data.
• Research and resolve unapplied/unidentified cash receipts.
• Reconciles payments and shortages for all batches.
• Sort & distribute any correspondence from the lockbox to the assigned collector.
• Scan any items as backup as necessary

Other:

• Maintains current knowledge of billing and reimbursement rules as designated by the Centers of Medicare and Medicaid Services (CMS), Medicaid Managed Care, and other payers.
• Maintains proficient knowledge of EHR, clearinghouse, and payer systems, as well as any other systems, required for performing required job duties.
• Communicates issues to management, including payer, system, or escalated account issues. Identifies denial trends and provide suggestions for resolution.
• Participates in department meetings, in-service programs, and continuing education programs.
• Maintains a professional attitude with patients, visitors, physicians, office staff and hospital personnel. Assures confidentiality of patient information, maintaining compliance with policies and procedures.
• Performs other duties as assigned.

Security/Access:

• Will have access to primary work location 24 hours a day.
• Will have access to confidential information abiding by the organizations privacy policies and regulations concerning this information.

Equipment Used:

• General office equipment to include:
  • fax, copier, computer, printer, etc.
• Telephone