- Perform timely analysis of payments or denials to determine appropriate accounting of billing submitted to
- Ensure batched payments are posted and/or adjusted within 72 hours of receipt.
- Reconcile all payments and accounts receivable, checking for accuracy and compliance with contract discounts.
- Contact third party payers to initiate adjustment if payment or denial is incorrect. Make necessary adjustments to
- Continuously monitor aging patient accounts to ensure unpaid claims are properly paid or adjudicated timely.
- Work closely with medical coder and third-party billing staff to ensure all claims are submitted with correct
- Verify eligibility and benefits for treatments and procedures working closely with Patient Registration Staff to
- Create and submit all accounts receivable and other reports to Revenue Cycle Manager at the end of every month
- Retrieve information from electronic health records to identify patient visits and encounters and review medical
- Identify medical documentation issues and resolve with appropriate staff members and providers without
- Perform audits and medical reviews by running error listings and/or other data reports to ensure documentation
- Answer all patient or insurance telephone inquiries. Set up patient payment plans and work collection accounts.
- Develop and maintain accounts receivable spreadsheets and run collection reports.
- Perform quality assurance/performance functions for the department to ensure quality of services are provided.
- Create and maintain records and logs which reflect accountability for all coding, billing and accounts receivable
- Maintain the integrity of patient information; including but not limited to, protecting from any unauthorized
- Keep abreast of the latest and new concepts and techniques in coding and billing regulations.
- Participate in the development of, accreditation, quality and other programs identified to improve patient care.
- Knowledge of Health information Management Systems including theory,
- Knowledge of RPMS and Electronic Health Record or other similar systems.
- Knowledge of International classification of Disease systems and reference
- Knowledge of medical terminology.
- Knowledge and adherence to the Privacy Act, HIPAA and HITECH
- Ability to work independently with minimal supervision.
- Skill in the compilation, analysis, collection, calculation and tabulation of
- Skill in computerized data entry and information processing systems.
- Ability to adhere to all professional and ethical behavior standards of the
- Ability and skill in communicating information both written and verbally
- Ability to follow verbal and written instructions.
- Ability to promote a positive working relationships with others and to work
- Principles and practices of medical records, laws, codes and regulations.
- Customer service techniques for dealing with a variety of individuals from
- Reading and explaining rules, policies and procedures.
- Knowledge of Microsoft Office Suite; Windows Explorer (electronic file handling), Microsoft Word; Microsoft Excel; internet software; and
- Basic operation of a workstation (turning on/off, knowledge of basic
- Ability to give full attention to what other people are saying, taking time to
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Accounting Technician - Albuquerque, United States - Laguna Healthcare Corporation
Description
POSITION LOCATED AT LAGUNA HEALTHCARE COPORATE OFFICES LOCATED AT:2929 Coors Blvd NW, Suite 306, Albuquerque, NM 87120POSITION SUMMARY
Under general supervision of the Revenue Cycle Manager, process payments from insurance companies and third-party payors. Maintain appropriate
accounting of clinic encounters by reviewing, analyzing, abstracting and compiling data and statistics. Review, audit and
correct errors; assist with the reconciliation of timely submittal of bills to third party payers. Review accounts receivable,
post payments and identify and correct denials. Audit billing, correct and re-submit bills to payers to collect for all services
rendered. Responsible for ensuring compliance with established coding guidelines, third party reimbursement policies,
regulations and accreditation guidelines.
ESSENTIAL FUNCTIONS
Research and appeal denied claims. Follow up with insurance companies regarding any discrepancy in payments.
adjustments to document legitimate reason for the adjustment.
consistency, completeness, accuracy for payments received.
breaches to the immediate supervisor.
MINIMUM QUALIFICATIONS
Associate Degree or Certificate in Accounting or Business Administration or High School Diploma
or GED with one (1) year of accounting/bookkeeping and/or billing/coding experience. RPMS
and IHS electronic health record experience preferred.
Accounting or Bookkeeping Certification preferred.
KNOWLEDGE, SKILLS AND ABILITIES
Physician Desk Reference (PDR), Current Procedural Terminology (CPT),
HCPCS, Diagnostic and Statistical Manual of Mental Disorders (DSM-V), use
of an encoder, and other coding references.
duties.
spelling, grammar and punctuation.
dealing with others.
the telephone.
usernames and passwords.
interrupting at inappropriate
times.
This position may be subject to a criminal history background check, a suitability background
check and/or a Fair Credit Reporting Act (FCRA) check. In addition, some positions are subject to a
more extensive background check to ensure compliance with Public Law Indian Child
Protection and Family Violence Prevention Act. Candidates must be able to successfully pass all
required background checks to qualify for this position. A record of satisfactory performance in all
prior and current employment as evidenced by positive employment references from previous and
current employers is also required.
All applicants must successfully pass a pre-employment drug/alcohol screening prior to beginning
employment and will be subject to random drug/alcohol testing.
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