Accounts Receivable/Billing Clerk

VALLEY COMPREHENSIVE COMMUNITY MENTAL HEALTH CENTER INC•Morgantown, WV

1d•Onsite

About The Position

Responsible for workflow and communication with programs on documentation corrections. Responsible for reports notifying programs and management the status of documentation. Responsible for scanning all paper documentation including downloading & maintaining all paper and electronic remittance and payment source documents/files. Responsible for reviewing remittances and documenting claims issues into program management system and notifying biller of denial or processing error. Assist billers in researching, submission of denied claims for Medicaid, MCO, invoice claims, and occasionally TPL denials. Assists in research to resolve partial payments and unapplied cash on client accounts. Reads and comprehends instructions and informs Revenue Cycle Manager of necessary issues for claim submission and resolution. Possesses the interpersonal skills necessary to interact with consumers and Valley staff, including managers, to resolve any billing questions/issues. Presents and projects a professional, business-like image to consumers and Valley staff.

Requirements

Ability to perform essential duties as outlined below.
High School diploma or equivalent.
Strong active listening skills.
Intermediate computer skills.
Intermediate knowledge of Microsoft Excel, Word, and Outlook.
Basic knowledge operating normal office equipment.
Ability to comprehend moderately complex instructions.
Ability to multi-task.
Strong attention to detail.
Ability to work in a team.
Demonstrate strong problem-solving abilities.
Ability to comply with Client’s Rights.
Ability to comply with Valley’s and division/departmental safety procedures.
Qualities of reliability, self-motivation, and a positive attitude.

Nice To Haves

Knowledge of medical terminology; CPT, ICD-10, and HCPCS.
Knowledge of health care insurance claim practices and compliance.
Knowledge of WV Medicaid policies and third-party billing practices.
Previous experience working in a medical office.
Previous experience in medical billing.
Possess basic knowledge of accounting practices.

Responsibilities

Batch and apply all cash receipts.
Accurately post payments into database both manually and electronically.
Audit and review payments for accuracy and compliance.
Review unapplied/unidentified payment issues to assure timely posting to client accounts.
Review private pay & complete any refunds – notify Revenue Cycle Manager of any billing issues.
Respond to customer inquiries and requests that may require extracting and analyzing system data.
Inform appropriate personnel of billing and/or procedural issues.
Establish and maintain constructive working relationships with coworkers, supervisors, managers, as well as external clients and other external business contacts.
Aid in the training of new employees.
Use the program management system to generate reports and transfer data from system to Microsoft Excel into easily readable format for programs/management and to research as directed.
Assure all request for service corrections are reviewed/completed within business day submitted and communicates status to necessary parties.
Assure the workflow for service correction is followed depending where in the cycle the service is in the billing cycle; unbilled in open accounting period, claimed, paid, or in a closed accounting period.
Confirm census is verified then compile and post daily room & board charges and saves all generated reports to folder following workflow procedure.
Scan all paper documentation and saves to the correct folder with naming convention procedures.
Maintain and file all paper documentation in the correct file cabinet/folder and attached to the correct paper claim.
Download and maintain all electronic remittance, 835payment, 270/271, 277, and 999 files to the correct folder and naming procedure.
Confirm 835, 270/271, 277, and 999 file is uploaded into Avatar and reviewed for acceptance, rejections, or errors and proceeds to research, correct, or inform responsible staff or department of the error.
Review all paper and electronic remittance for denials or communications from guarantor adjudication and records the denial in program management system using the appropriate form(s).
Inform the biller or other responsible department(s) of the denial or partial denial or communications from the guarantor.
Review billing/payment activity on consumer accounts for accuracy and makes necessary corrections as directed.
Answer phone calls, emails concerning any financial account questions from clients, staff, and/or physicians.
Effectively and professionally resolve issues with clients and insurance payers.
Monitor, maintain, and use appropriately, all equipment and supplies.
Other duties as assigned.