About the Role
Performs all duties required to ensure accurate distribution of patient/insurance payments and appropriate adjustments to patient accounts. Carries out all duties while respecting patient confidentiality and promoting the mission and philosophy of the organization.
Responsibilities
- Audits patient accounts to resolve all credits and undistributed activity.
- Researches and resolves all credits assigned through daily distributions and reports.
- Reviews carrier explanation of benefits to determine accurate reflection of carrier, provider, and patient responsibility.
- Opens payment posting or adjustment batch to perform appropriate account maintenance activity to balance claim activity.
- Distributes or redistributes payments and adjustments to the correct invoice and date of service.
- Generates adjustments necessary to complete correct posting of payments and adjustments using appropriate A/R and ANSI codes.
- Ensures accurate transfer of outstanding balances to the next responsible party as indicated by payer explanation of benefits.
- Assists with training of new employees.
- Compiles and submits patient and insurance refunds according to established policy and procedure with all supporting documentation.
- Reviews and files all secondary insurance claims attaching carrier explanations of benefits for designated plans.
- Completes clear and accurate account notes to document issue, source, and resolution of all account maintenance activity.
- Obtains supervisor signature on all large dollar write-offs according to established policy.
- Follows established guidelines to complete all report activity to meet month-end deadlines.
- Documents daily performance in weekly productivity log.
- Researches and processes patient credit card refunds in Epic.
- Distributes daily credit batches to staff.
- Assists and processes Agency notifications.
- Maintains work queues to perform necessary account maintenance processes according to established policy and procedure.
- Utilizes payer web site systems & tools to obtain accurate patient eligibility and claim payment details.
- Attends meetings as requested.
- Adheres to all company policies, including OSHA, HIPAA, compliance, and Code of Conduct.
- Maintains regular and dependable attendance.
- Follows the core competencies set forth by the Company.
- Keeps complete, accessible, dated files.
- Identifies training needs of the Team and works with the Team Leader and Supervisor to provide.
- Aids coworkers as requested and/or necessary.
- Provides workload statistic reports to management team.
- Responds professionally and effectively to questions from external sources and internal sources.
- Attends required in-services/training.
- Assists with training staff.
- Performs other duties as assigned.
Requirements
- High school diploma or GED equivalent.
- Requires at least 1-2 years of related experience working with medical billing in a practice facility setting.
- Ability to sit for extended periods of time at a computer workstation.
- Excellent verbal and written communication skills required to communicate clearly and effectively to all levels of staff and the public.
- Accurate ten-key by touch.
- Basic knowledge of accounting and banking practices.
Skills
- Knowledge using computer data processing systems.
- Knowledge of and experience in ANSI denial codes.
- Knowledge of and experience in effective use of CPT, ICD-9 and HCPCS coding.
- Knowledge of legislative and private sector third-party regulations and guidelines.
- Ability to engage others, listen and adapt response to meet others’ needs.
- Ability to align own actions with those of other team members committed to common goals.
- Excellent computer and keyboarding skills, including familiarity with Windows.
- Excellent verbal and written communication skills.
- Ability to manage competing priorities.
- Ability to always perform job duties in a professional manner.
- Ability to understand, recall, and communicate information.
- Ability to organize thoughts and ideas into understandable terminology.
- Ability to apply common sense in performing job.
- Ability to focus on win-win communication when conflicts, problems, or misunderstandings arise.
- Ability to organize and prioritize own work schedule.
Location
- Central Texas
Work Type
- Full-time
Experience Level
- 1-2 years
Education Level
- High school diploma or GED equivalent
Benefits
- Medical
- Dental
- Vision
- Flexible Spending Accounts
- PTO
- 401(k)
- EAP
- Life Insurance
- Long Term Disability
- Tuition Reimbursement
- Child Care Assistance
- Health & Fitness
- Sick Child Care Assistance
- Development
About the Company
- Austin Regional Clinic has been voted a top Central Texas employer by our employees for over 15 years!
- We are one of central Texas’ largest professional medical groups with 35+ locations and we are continuing to grow.
