MountainView Hospital

  • Idaho Falls, ID


  • Permanent

  • Full-time

Job Details Level Experienced Job Location Business Office – Idaho Falls, ID Position Type Full time Education Level CPC-Certified Professional Coder Salary Range Undisclosed Travel Percentage Undisclosed Job Shift Undisclosed Job Category Admin – Clerical Description JOB SUMMARY: Performs all duties related to the collection of accounts receivable. Establishes payment arrangements with patients in order to collect on accounts and is also responsible for maintaining patient accounts from the time they are billed until payment is received. Notes every account worked. Refunds overpayments according to refund policy. Admits, charges, codes the diagnosis codes, and bills each patient account. Posts payments to accounts that are received in the mail or through the lock box as needed. Files all insurance according to State and Federal guidelines. Checks with patient insurance to see if a prior authorization is required and obtains prior authorization for services prior to services being rendered if required. . Contact insurance via phone and/or web to review patient benefits and calculate patient estimate portion based on benefits DUTIES AND RESPONSIBILITIES: Billing/Coding Clerk 1. Researches all information needed to complete billing process including getting charge information from physicians. 2. Codes information about procedures performed and diagnosis on charges. 3. Keys charge information into billing software program and produces billing. 4. Enters payments from insurance companies from EOB’s and patient payments. 5. Prepares bank deposits, records deposits, photocopies checks for entry into billing system. 6. Responsible for follow-up on accounts until zero balance or turned over for collections. 7. Assists with coding and error resolution. 8. Answers billing calls and helps provide patient information assistance when needed. 9. Reviews EOB’s/payments and verifies that accounts are being paid according to contract. 10. Sorts/files correspondence and maintains items in date order. Responsible to work and follow-up on reminders daily. 11. Processes non-clinical appeals on accounts when appropriate. Sends requests to medical records as needed. 12. Responsible for rebilling claims when required. Responsible for contacting responsible party if additional information is requested for billing purposes. Responsible for notifying insured of insurance denials. 13. Processes denials from insurance EOB’s weekly. 14. Identifies problem accounts as well as claims processing delays and escalates to management. 15. Maintains various payers bulletins and educational updates in work area 16. Attends/participates in all available educational opportunities to stay in compliance with insurance and government regulations. 17. Maintains patient confidentiality at all times 18. Responsible for knowing policies and being familiar with services offered. 19. Performs other job related duties as assigned by management. 20. The employee is required to comply with all PCI standards and other company policies and procedures for payment card acceptance and security. Qualifications QUALIFICATIONS: Education/Certification: High school diploma or general education degree (GED). Must be CPC certified. Experience: One to three months related experience and/or training; or equivalent combination of education and experience. Equipment/Technology: Ability to use clinic billing system, and operate basic computer functions and software. Language/Communication: Ability to read and interpret documents such as patient statements, safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization. Mathematical Skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percentages and to draw and interpret bar graphs. Mental Capabilities: Ability to apply common sense to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. Interpersonal: Ability to work well with others.

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