DHR Health

DHR Health

  • Edinburg, TX
  • Permanent
  • Full-time
Description

Position at Renaissance Medical Foundation

Full-time – Days

POSITION SUMMARY:

This position is accountable for preparing precise and certified claims to be billed to Medicare, Medicaid and other insurer either electronic or paper and fixing any claim mistakes prior to claims submission and should likewise make sure that claims billed do not surpass the prompt filing limitations and re-submit any claim as essential.

POSITION EDUCATION/QUALIFICATIONS:

  • High School Diploma/GED is chosen
  • Two (2) years billing experience in an MD workplace or healthcare facility setting chosen
  • Basic computer system abilities and the capability to utilize Excel and Microsoft workplace items are needed
  • Knowledge of health care repayment is needed
  • Good composed and spoken interaction abilities are needed.
  • Ability to check out, compose and speak English
  • Ability to interact plainly and concisely with all levels of Management

JOB KNOWLEDGE, SKILLS, AND EXPERIENCE:

  • Communicates plainly and concisely and has the ability to work successfully with other workers, clients and external celebrations
  • Establishes and keeps long-lasting consumer relationships, developing connection with other department personnel
  • Demonstrates efficiency in Microsoft Office applications, have the ability to type a minimum of 35 WPM.
  • Able to carry out fundamental mathematical estimations, balance and fix up figures, stress correctly and spell properly
  • Requires thinking capability, great independent judgment and dealing with regular disruptions
  • Medical Terminology, ICD-9 Codes, CPT Codes, HCPCS code, and Modifier understanding is chosen
  • Ability to utilize the web to get info from Third Party Payers or other sources is needed

POSITION RESPONSIBILITIES:

  • Promotes the center objective, vision and worths by successfully interacting them to others. Thinks about objective, vision and worths in establishing services, requirements and practices
  • Demonstrates efficiency in billing and follow up of Medicare and Medicaid declares online or through billing software application
  • Ability to utilize the web for TMHP gain access to, and insurance coverage confirmation websites.
  • Submits changed claims to Medicare through online automatic system.
  • Daily, works all recognized insurance coverage modifies through electronic billing system and work administrator.
  • Transmits all info to the billing supplier daily for electronic claims filing
  • References upgraded ICD-9-CM/ ICD-10- CM, CPT, Modifiers and HCPCS Level II code books/on line as required
  • Works and acts on the work administrator report and resubmits the claims daily to billing supplier
  • Works rejected claims or appeals through the electronic billing system everyday
  • Mails paper declares to the insurance coverage providers according to requirement daily
  • Works the accepted and declined reports from the billing supplier and files on client management in the proper account
  • Prepares the billing packages for billing supplier everyday
  • Communicates billing problems with the supervisor/manager right away
  • Responsible to send out ticklers to Coding as required for information on medical diagnosis, CPT, HCPCS, or Modifier
  • Utilizes tickler, when asking for extra details from other colleagues or departments
  • Ensures that all important account activity is recorded 100% by going into the documents into the computer system notes
  • Reads any upgraded, modifications and corrections required by the provider
  • Proficient in accessing details required from Cerner and AX record imaging software application to gain access to medical records from Cerner system to appeal claims with providers
  • Request copies of medical records for any paper records
  • Ensures client privacy requirements are satisfied in accordance with HIPAA policies and treatments
  • Other tasks as designated

DHR Health

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