Brief Job Summary:
Billing Representative will assist with internal claims processes and procedures while maintaining current information to provide accurate data.
Responsibilities & Duties:
- Perform Charge Entry and Payment Posting
- Correct errors and denials to resolve coding issues and applying appropriate corrections.
- Review provider documentation to ensure documented services are captured and appropriate codes are assigned.
- Cross- Training is required as all reps work in billing (Medical and Dental)
- Provide the clinic and authorized specialists with appropriate assignment of ICD, CPT, and Healthcare Common Procedure Coding System (HCPCS) coding.
- Coordinates with Supervisor on training needs for providers in coding and maximizing reimbursement.
- Evolve to become proficient in the following aspects of billing at Harvard Street Neighborhood Health Center:
Daily Responsibilities for Claims:
- Hold claims/ Manager holds claims
- Work closely with Athena and Payer’s
- Coding changes
- Correct denials and rejections
- Process claims submissions and resubmissions.
- Correct rejected Medicare claims through the Medicare DDE System
- Modifier updates, additions and changes
- Payer eligibility confirmation
- Authorization confirmation
- Research and reporting missing slips
- Athena configuration changes
- ICD-10 training and updates
- Dental charge entry (many rules to be applied manually)
- Payment posting – (major part workload)
- HSN updates
- Research outstanding claims
- Updates related to new payer guidelines
- Certification by American Academy of Professional Coders (CPC) or Certified Coding Specialist (CCS) within one year of employment.
- Critical thinking skills
- Extreme attention to detail with follow up and follow through on all tasks
- Work independently and as a team
- Experience with healthcare claims management systems.
- Knowledge of medical terminology; ICD-9, CPT and HCPCS experience preferred.
Harvard Street Neighborhood Health Center is an Equal Opportunity & Affirmative Action Employer
Hours per Week: