Central Billing Representative I

First Choice Community Healthcare•Albuquerque, NM

6d•Onsite

About The Position

Under the direct supervision of the Director of Revenue Cycle Management, the Central Billing Representative I is responsible for maintaining a high-performance work environment characterized by positive relationships and a strong orientation towards customer service and timely quality patient billing. The Central Billing Representative I is responsible for direct interaction and assistance to Site Biller Representatives, patients, physicians, colleagues, contractors and consultants for the purpose of billing, collection and reporting of multi-specialty self-pay, third party payer accounts receivable and claims on a daily basis.

Requirements

High school degree or GED
One to three years data entry and billing and claims experience in healthcare setting or FCCH billing externship
Experience in a multispecialty clinic setting

Nice To Haves

Certified Coder (medical and/or dental)
Billing Certificate, the result of graduation from a certified billing school
Coder and/or Billing Certificate may be substituted with demonstrated proficient knowledge of procedural CPT & Dental Coding and/or ICD-10 diagnosis coding
General knowledge of computerized practice management systems, preferably Cerner PWPM Practice Management System, Cerner Electronic Health Record System and Dentrix Dental billing and E H R
Ability to learn billing and collection system within federally chartered community health centers (CHC) and RHI/UHI programs
Ability to communicate with tact and diplomacy with diverse groups of people including staff, providers, and insurance companies on behalf of the organization
Ability to display sensitivity to the patient population being served
Ability to work on a variety of assignments concurrently within established deadlines
Ability to work with others in a problem solving and team environment and to work alongside staff as needed
Knowledge of HIPAA as it relates to medical, dental & behavioral health billing
Position requires a high level of accuracy and attention to detail
Ability to communicate effectively, both orally and in writing
Ability to respond effectively to sensitive inquiries or complaints
Ability to work independently with minimal supervision
Proficient with computers and MS Windows software programs
Knowledge of Federally Qualified Health Care billing and reimbursement preferred
Working knowledge of CPT, Dental ADA, DSM V and ICD-10 preferred
Knowledge of Medicare and Medicaid guidelines
General knowledge of UB04, HCFA1500 and Dental ADA Electronic and Paper claim forms
Knowledge and familiarity with compliance program. Cooperate fully and comply with laws and regulations

Responsibilities

Review of site batched patient encounters for charge and payment accuracy, as needed including encounter rate and or other necessary billing adjustments
Monitor and review site unbilled encounters and assist when necessary to meet mutual daily and weekly deadlines
Provide education on encounter batches as appropriate to minimize error reoccurrence and support maximum reimbursement
Meet all EOM (end of month) closing activities and deadlines
Coordinate electronic patient statements on a monthly basis
Post payments received and reconcile system postings to lockbox &/or EOB (explanation of benefits) totals
Record NSF checks returned by bank and notify patient of adjusted balance due
Review credit balance reports and prepare refund requests for overpayments
Participate in billing Helpdesk customer support, by receiving, responding and documenting all incoming account inquiries including electronic, telephone and written correspondence related to billing issues
Review and resolve all EOB’s including those without payment to initiate clean claim resubmission and claim reimbursement
Demonstrate ability to edit & submit insurance claims for fee for service and prospective payment system reimbursement
Resolve unapplied cash, errors in cash reconciliation and changes in payment allocation to insurance payer types
Communicate payment terms and establish agreed-upon payment plans for overdue patient and insurance account balances. Monitor payment compliance with terms of established plans with patients and insurance plan provider representatives
Evaluate uncollectible patient and insurance accounts and make recommendations concerning account write-offs and/or placement as bad debt status
Complete bad debt process based on FCCH procedure
Document activities on accounts, including corrections and collection activities in the practice management system and additional MS Word software tools provided
Initiate & complete account adjustments to correct account balance and/or comply with contractual and sliding fee scale requirements
Assist and train other staff members as requested in the areas of registration and billing
Assist Site Biller Representatives and cover and perform their functions in their absence
Responsible for all other duties as assigned