About The Position

Under general supervision and in accordance with established policies and procedures, is responsible for the daily charge entry, processing, billing, and payment posting for Sheppard Pratt for all lines of business. Uses patient information management system and computerized billing system to initiate and update patient accounts, generate data required for preparation of third-party claims and client statements, and adjust third party/self-pay data. Uses the McKesson Horizon Patient Folder (HPF) system to promote a paperless environment to post electronic payments, post payments and charges to the IDX system, and review and access EOB data for electronic billing. In addition, uses the McKesson HPF system to obtain copies of explanation of benefits (EOB), referrals, and other documentation necessary for both primary and secondary billing. Uses the Allscripts system to submit physician charges electronically through to the IDX system. Prepares and maintains required documentation in accordance with department policy and procedures. The vast majority of this position involves interaction with insurance companies with only a very small percentage involving interaction with clinicians and patients.

Requirements

  • Work requires the ability to read, write, and speak English in order to effectively communicate with a wide variety of people regarding billing policies and procedures and patient account issues; to perform arithmetic computations; to adjust debits and credits; and to type at acceptable levels of speed and accuracy in order to compose and proofread business correspondence acquired through a generalized high school education or by a relatively brief (six months or less) period of intensive training outside of high school in basic accounting or bookkeeping.
  • Work requires knowledge of billing practices and procedures, collections, and third-party reimbursement procedures; experience calculating allowances, deductibles, co-pays, and coinsurances, and familiarity with computerized billing systems - acquired through six to twelve months' experience in related billing and health insurance work.
  • Work requires proficiency in using common office equipment (i.e., PC, calculator, etc.); proficiency in Allscripts direct charge entry system and McKesson Horizon Patient folder system acquired through on-the-job training.

Nice To Haves

  • Follow-up and Medicaid experience strongly preferred.

Responsibilities

  • daily charge entry
  • processing
  • billing
  • payment posting for Sheppard Pratt for all lines of business
  • initiate and update patient accounts
  • generate data required for preparation of third-party claims and client statements
  • adjust third party/self-pay data
  • post electronic payments
  • post payments and charges to the IDX system
  • review and access EOB data for electronic billing
  • obtain copies of explanation of benefits (EOB), referrals, and other documentation necessary for both primary and secondary billing
  • submit physician charges electronically through to the IDX system
  • prepares and maintains required documentation in accordance with department policy and procedures

Benefits

  • A commitment to professional development, including a comprehensive tuition reimbursement program to support ongoing education and licensure and/or certification preparation
  • Comprehensive medical, dental and vision benefits for benefit eligible positions
  • 403b retirement match
  • Generous paid-time-off for benefit eligible positions
  • Complimentary Employee Assistance Program (EAP)
  • Generous mileage reimbursement program
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