RHC Billing/Coding Specialist

Cleveland Area Hospital•Cleveland, OK

just now

About The Position

Under the direction of the Revenue Manager for Lake Area Medical Associates, this position will be responsible for ensuring quality, productivity, and an even flow of work daily. The RHC Billing Specialist will have quick typing skills, an analytical mind, exceptional attention to detail, and a passion for precision.

Requirements

High school graduate or equivalent
Skilled in MS Excel (VLOOKUP, formulas, Pivot tables), MS Word.
Excellent mathematical skills.
Excellent attention to detail.
Excellent communication skills, including letters, memos, and emails.
Excellent customer service and telephone skills.
2-3 years of Rural Health Clinic billing experience

Nice To Haves

Preferred experience in cash posting.
Preferred experience in Athena and Cerner hospital software.

Responsibilities

Knowledge of insurance, including HMO/PPO, Medicare, Medicaid, Managed Medicare rules and guidelines.
Interpreting EOBs for verifying the accuracy of insurance payer payments, adjustments, and denials.
Initiating appeals for denied claims.
Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
Checking each insurance payment for accuracy and compliance with the contract discount.
Responsible for the timely and accurate posting of all payments and other postings.
Performs AR Follow-up.
Makes collection phone calls.
Answers patient billing questions.
Performs Financial Counseling as needed.
Performs reports as needed.
Reviews accounts for outsourced collections.
Answers Patient Portal billing questions.
Assist with DNFB and Aging for RHC and Hospital as requested.
Performs Insurance Credentialing for Hospital and RHC.
Assigns the appropriate ICD-CM-10 code.
Assigns appropriate Modifiers, CPT, and HCPCS.
Adheres to AHIMA Ethical coding guidelines.
Adheres to CPT and HCPC coding guidelines.
Excellent customer service.
Adhere to all policies of the organization, including (but not limited to) job description, certification/licensure requirements, mission statement, HIPAA, confidentiality standards, and patients’ rights.
Demonstrates professionalism and accountability
Demonstrates a caring attitude consistent with Cleveland Area Hospital toward patients, family members, employees, and other facility guests
Demonstrates excellent communication skills
Identifies and utilizes appropriate channels of communication.
Adheres to the organization’s Mission, Vision, and Values
Participates in departmental activities, meetings, and in-services, and follows established guidelines