Great Plains Tribal Chairmen & Health Board.

  • Rapid City, SD


  • Irreversible.

  • Full-time.

Job Summary:

The Billing Coordinator works as an insurance coverage Biller for all 3rd party claims, consisting of Medicare, Medicaid, VA and Private Insurance. The billing organizer will be accountable for the analysis of medical details from the electronic health record (EHR) encounter and the Resource and Patient Management System (RPMS) to make sure the prompt submission of precise claims to third-party payers. The Billing Coordinator is accountable for the tracking and follow-up of all claims to validate correct repayment is gotten in addition to the correction or appealing of rejections.

Essential Functions:

  • Prepare, procedure and send tidy claims to different insurance coverage declares according to payer standards and due dates either digitally or by paper.
  • Maintain existing understanding and understanding of each insurance coverage payer’s guidelines, policies and due dates and use this understanding in day-to-day responsibilities and projects
  • Recognize and recognize mistakes and interact these to insurance coverage payers and/or Lead Biller.
  • Monitor and fix up overdue accounts.
  • Identify and fix inaccurate rejections.
  • Documented capability to focus on work and fulfill quality and production requirements.
  • Effectively interact with clearinghouse and insurance provider concerning claim status, consisting of rejections, rejections, corrections and other numerous problems.
  • Communicate with coding department concerning coding-related rejections requiring correction.
  • Provide proper third-party account status and any concerns to Lead Biller or Business Office Manager.
  • Responsible for everyday clearinghouse reconciliation of reports and claims.
  • Answer concerns from clients, clerical personnel, people, subcontractors and insurer.
  • Perform different collection actions consisting of getting in touch with by phone, fixing and resubmitting claims to 3rd party payers.
  • Participate in CMS, IHS and personal insurance companies’ academic activities as essential.
  • Conduct self in accordance with GPTCHB’s worker handbook.
  • Maintain rigorous privacy; comply with all HIPAA guidelines/regulations.
  • Perform other associated responsibilities as designated.

Professional Behavior

  • Effectively strategy, arrange work and schedule time to fulfill the needs of the position.
  • Work in a cooperative and expert way with OHC and GPTCHB personnel.
  • Treat Great Plains people and partners with self-respect and regard.
  • Utilize efficient spoken and written interaction abilities.
  • Advance individual instructional advancement by going to training sessions and workshops as proper.
  • Exemplify exceptional client service with tribal stakeholders, health board associates, program partners, service receivers, visitors and visitors.
  • Foster a workplace of health, courtesy, friendliness, helpfulness and regard.
  • Relate well and work collaboratively with colleagues and all levels of personnel in an expert way.
  • Consistently show regard for and approval of varying abilities, cultures, gender, age, sexual preference and/or characters.
  • Maintain and make sure organizational personal privacy and privacy.
  • Handle crisis and endure tension expertly.
  • Be self-directed and take proactive effort to help others.
  • Resolve concerns with other departments and colleagues without direct guidance if required.
  • Exercise versatility to change plans/routines when scenarios need and continue to carry out without forecasting stress/frustration that would negatively impact the workplace.
  • Promote an alcohol, tobacco and drug-free way of life.
  • Embrace modes of look and clothes that show an expert existence.
  • Adhere to GPTCHB policies and treatments.

Knowledge Required

  • Advanced understanding of medical billing coding practices, Medicaid/Medicare, Worker’s Compensation, all business insurance coverage providers and other 3rd party repayment resources.
  • Knowledge of medical billing and accounting treatments and applications.
  • Knowledge of claims evaluation, analysis and quality control.
  • Knowledge of fundamental medical terms consisting of prefixes, suffixes, basic abbreviations, and pharmaceutical terms and center procedures.
  • Knowledge of third-party claims submission procedure and capability to keep existing on modifications in policies, guidelines of eligibility.
  • Knowledge and ability adequate to analyze terms utilized by service providers in EHR.
  • Knowledge of CMS and personal insurance provider’s standards.
  • Knowledge of anatomy and physiology and significant physiological signs.
  • Knowledge of ICD-10 and CPT 4 and HCPCS coding treatments.
  • Knowledge of modifications in federal government policies, collection laws, 3rd party treatments and internal treatments.
  • Skill in utilizing a computer system for evaluating encounters and informing companies of information that requires corrections through the EHR broadcast, alerts and design templates.
  • Exemplify outstanding client service with tribal stakeholders, health board associates, program partners, service receivers, visitors and visitors.
  • Foster a workplace of health, courtesy, friendliness, helpfulness and regard.
  • Familiarity and/or experience working with American Indian populations and regard for and understanding of conventional, cultural and spiritual practices of varied American Indian neighborhoods, along with a capability to deal with other culturally and ethnically varied populations.
  • Consistently show regard for and approval of varying abilities, cultures, gender, age, sexual preference and/or characters.
  • Maintain and guarantee organizational personal privacy and privacy.
  • Must have the ability to manage crisis and endure tension expertly.
  • Must be self-directed and take proactive effort to help others.
  • Possess the capability to fix problems with other departments and colleagues without direct guidance.
  • Able to work out versatility to modify plans/routines when circumstances need and continue to carry out without predicting stress/frustration that would negatively impact the workplace.
  • Ability to keep a versatile work schedule, consisting of nights, weekends and over night or prolonged travel as required.
  • Proficiency with computer system programs (Word, Excel, PowerPoint) and other Internet innovations.
  • Valid motorist’s license should be kept present, and certificates, qualifications or licenses need to be kept existing and constant with guidelines needed by appropriate federal, state and/or grant guidelines.
  • Ability to promote an alcohol-, tobacco- and drug-free way of life.
  • Embrace modes of look and clothes that show an expert existence.
  • Adhere to GPTCHB policies and treatments.

Supervisory Controls

The manager makes tasks by specifying goals, concerns, and due dates and helps the staff member with uncommon circumstances that do not have clear precedents.

The staff member strategies and performs the succeeding actions and deals with issues and variances in the work tasks in accordance with guidelines, policies, previous training, scope of license/certification, or accepted practices in the profession.

Completed work is generally examined for technical stability, suitability, and conformity to policy and requirements. The approaches utilized in reaching completion outcomes are not generally examined in information.

Guidelines

Guidelines consist of guidelines from federal, state and regional alternate resource firms; Department of Health and Human Resources Services guidelines; GPTCHB, OHC, and department policies and treatments. These standards need judgment, choice and analysis in application. This position helps in the advancement of workplace policies and standards.

Complexity/Scope of Work

The work consists of some variations, and might include various and unassociated procedures and approaches. The choice concerning what requires to be done relies on the analysis of the topic, stage, or concerns associated with each project, and the picked strategy might need to be chosen from numerous options.

Contacts

The individual contacts are with workers throughout the company and are typically taken part in various functions and sort of work, and might be agents from numerous levels. Other individual contacts at this level consist of contact with partner companies, Tribal affiliate companies, and members of the public.

Work Environment/Physical Demands

The particular needs explained here are representative of those that should be satisfied by a worker to effectively carry out the necessary functions of the task.

While carrying out the tasks of this task, the staff member is regularly needed to stand, stroll, sit and utilize hands to finger, manage or feel. The worker is frequently needed to stoop, kneel, crouch or crawl. The staff member needs to routinely raise and/or go up to 25 pounds and regularly lift and/or go up to 50 pounds. The staff member is sometimes exposed to outdoors weather. The sound level in the workplace is normally moderate.

Reasonable lodgings might be made to make it possible for people with impairments to carry out the vital functions.

Travel: Minimal travel might be needed to take part in needed trainings.

Supervisory and Management Responsibility

This position has actually no officially appointed supervisory obligation or authority. The worker is accountable just for the efficiency of their own appointed work. They might be asked to train brand-new staff members in the principles of the tasks or to take part in cross-training of other staff members in the department, however such projects do not consist of the on-going authority to appoint and evaluate work of other staff members or to advise or take restorative action with regard to other staff members’ efficiency.

Minimum Qualifications

  • High school diploma or comparable needed with one (1) year of medical workplace experience, adequate to comprehend the significant tasks of the position; medical billing experience chosen.
  • AAPC or AHIMA accreditation needed, or obtainable within 6 (6) months.
  • Experience with RPMS and EHR chosen.
  • Excellent spoken and written interaction abilities with the capability to be information oriented.
  • Computer and technical abilities (consisting of Word, PowerPoint, Excel, Outlook, and so on).
  • Experience that shows the capability to engage efficiently with leaders amongst American Indian neighborhoods, federal government companies, clinical and scholastic neighborhoods, medical and health-related companies, nongovernmental groups and the general public at big is needed.
  • Possession of or capability to easily get a legitimate motorist’s license provided by the State of South Dakota.

The GPTCHB is a tribal company which follows tribal choice laws. It is our policy to provide choice to certified Indian/Tribal prospects over certified non-native prospects in working with choices, if all other certifications are equivalent.

Must effectively pass a criminal and background check and a pre-employment drug screen.

Great Plains Tribal Chairmen & Health Board.

  • Apply Now.