Billing Representative III

Primary Health Care Inc•Des Moines, IA

11h•$19 - $28

About The Position

As a Billing Representative III, you will be is responsible for timely and accurate submission, payment posting and follow up of medical and/or dental claims on behalf of PHC. Provides work direction and conducts the training and auditing of the first and second level Billing Representatives. Routinely interacts with various internal and external contacts, including management, third party payers, government agencies and fiscal intermediaries to effectively file claims, research and resolve rejections and denials. Completes daily and monthly reporting, ensuring compliance with all State and Federal and third-party payer requirements regarding confidentiality and billing. Responds in a timely manner to billing or patient account inquiries. Demonstrates iCare values in daily work. What's Great About this Position? Earn 4 weeks of PTO throughout your first year of employment and enjoy paid holidays as well. Continue to develop your skills and grow your career through PHC’s training opportunities including: PHC University, Emerging Leaders, and medical and dental assistant training programs. Work in a collaborative team atmosphere in a fast paced environment.

Requirements

Associates degree or equivalent combination of education and experience.
Minimum of 3 years of experience in healthcare billing and using healthcare billing software.
Experience working with CDT/CPT codes for all dental/medical insurance carriers.
Experience working with CDT/CPT and ICD-10-CM coding related to managed care programs and dental/medical billing requirements.
Experience working with dental/medical insurance contractual agreements, Medicare and Medicaid regulations, payment and recoupments.
Reading and analysis skills with ability to interpret remittance advice with remark codes and denial information.
Strong technical knowledge and expertise.
Excellent written and verbal communication skills.
Exceptional interpersonal and customer services skills.
Excellent computer skills with proficiency using Microsoft Office applications.
Training and facilitation skills.

Nice To Haves

Team lead experience
Bachelor’s Degree in health information or related field
Experience with electronic medical/dental records.
Bilingual, verbal and written language proficiency.
Community Health Center experience

Responsibilities

Facilitates training for the billing team. Provides one-on-one and group training to new and existing staff using various approaches such as but not limited to on-the job training, written manuals and demonstration. Communicates on-going support, cross training, and feedback to the billing team members as needed. Provides feedback to the Director of Revenue Cycle on team members who may need additional performance coaching. Creates and maintains training workflows and documentation to represent current practices via auditing, workflows monthly.
Conducts daily and weekly audits of accounts and batches to ensure all unapplied funds have been applied correctly and that all posted payments have moved claims to the appropriate status. Provides feedback to Practice Management Support as needed with appropriate follow up on system issues as discovered.
Serves as billing team leader, including delegating tasks in the absence of the Director of Revenue Cycle, completing month end closing procedures, and working necessary financial reports. Collaborates with Director of Revenue Cycle to set priorities for excellent productivity. Monitors billing team work completion, identifies priorities, and assigns tasks to team members. Delegates specific tasks forwarded by COS/HBS staff for immediate resolution.
Works effectively to maintain billing rejects to a rate of less than 5% through audits and training, group and individual training.
Completes daily input of charges and ensures compliance with established goals for billing, including the timely submission of all clinic charges and daily editing, ensuring appropriate coding, pay codes, etc. Ensures compliance with all State and Federal patient financial service requirements, including, but not limited to patient-rights, confidentiality, and third-party billing.
Responds appropriately to inquiries on accounts by patients or third-party payors. Reviews and disseminates incoming correspondence, including mailed denials, within 48 hours of receipt.