Medical Records Tech (Biller) - OCAO - IHS

MCSG Technologies•Oklahoma City, OK

11d•Onsite

About The Position

The Medical Records Technician – Biller supports management in planning and delivering Business Office Department services throughout the Oklahoma Area. The role handles third-party billing and accounts receivable for outpatient and inpatient care, including reviewing medical records, coding services, preparing and submitting claims, correcting errors, and responding to payer requirements. It also verifies patient insurance eligibility, coordinates authorizations and release-of-information forms, safeguards confidential records, and provides administrative support related to claims processing and Alternate Resources collections. The position requires extreme accuracy and timeliness, tact in working with employees and patients, and a background check. A Public Trust security clearance is required.

Requirements

Background check required.
Public Trust security clearance required.
Extreme accuracy and timeliness in all phases of work.
Considerable tact in maintaining effective working relationships with employees, clientele, and patients.
Working knowledge of accounting skills to maintain ledgers of submittals and collections, commitment registers, and interpret computer printouts, vouchers, and schedules.

Responsibilities

Prepare and submit accurate, timely outpatient and inpatient claims to third-party payers, intermediaries, and responsible parties within established deadlines.
Review daily system reports to identify claims ready for billing, notify the supervisor of unbillable claims and reasons, and submit a daily productivity report.
Respond to payer requirements involving post-payment reviews, exclusions, denials, and appeals; audit claims and medical records for documentation and accountability.
Transmit approved claims within one business day, ensure electronic transmissions are HIPAA compliant, reconcile transmission and confirmation reports, and correct errors.
Review medical records for appropriate documentation, diagnoses, provider signatures, dates of service, and compliance with attestation and billing requirements; report discrepancies for resolution before claims are transmitted.
Verify patients’ current third-party insurance eligibility and identifying information by contacting Federal, State, and County agencies, and notify carriers within required periods.
Prepare and compile authorizations, assignments of benefits, release-of-information forms, and other documents needed for prior approval, pre-certification, and benefits determinations.
Search patient health records and assign and sequence applicable ICD, CPT, and HCPCS codes; verify diagnoses, procedures, and Evaluation and Management levels.
Monitor the inpatient daily census and research the Admission Discharge Transfer system; notify appropriate staff when records or processes require attention.
Complete and review UB-04, CMS-1500, and other required billing forms before submission, ensuring they accurately reflect services rendered.
Correct rejected or suspended claims and maintain current documentation of account activity in the RPMS accounts receivable message field.
Establish and maintain day-to-day billing procedures and files, and recommend procedural changes to the supervisor.
Maintain ledgers and related billing and collections records, interpret financial system reports and documents, and maintain applicable insurance and coding manuals and directives.
Communicate with agency, payer, Social Security, State Medical Office, PRO, and Service Unit personnel to resolve application, system, claims, and coding issues.
Respond to information requests and administrative inquiries, identify needed information or recommendations, and prepare or follow up on responses.
Safeguard claims and medical records as privileged communications and disclose information only within the limits of IHS policy.
Read third-party updates and attend available continuing education opportunities.