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Posted: 19-Feb-25
Location: Santa Fe, New Mexico
Categories:
Internal Number: 70059216
POSITION SUMMARY: Responsible for performing billing, collections and reimbursement services of claims and duties of the clinician group business office. In doing so, ensures that all claims billed and collected meet all government-mandated procedures for Integrity and Compliance.
Requirements
EDUCATION: HS Diploma or equivalency required
CERTIFICATION/LICENSES: None required
SKILLS:
- Must have good verbal and written communication skills in order to present and explain information to internal and external customers.
- Ability to write letters using proper English, grammar, spelling, vocabulary, and punctuation
- Must have practical experience with Adobe, Word, Excel and Microsoft Outlook applications. Also, any other computer applications related to the work (document imaging systems, Organizational Share Point, Revenue Cycle systems)
- Must have ability to make independent decisions that are generally guided by established procedures.
- Must have a desire to learn ethical and compliant business practices.
- Must be able to handle sensitive, stressful and confidential situations and account information.
- Must have excellent keyboarding and 10-key skill-set.
- Must have knowledge to perform functions requiring the use of the Internet.
- Willingness and ability to learn new task.
- Understanding of alternative Business Office financial resources
- Ability to provide information and/or recommendations related to sources of recovery
- Knowledge of general medical A/R accounts
- Knowledge of one or more of the following:
- Insurance registration, loading and filing order
- Insurance authorization and medical necessity requirements
- Reading and comprehension of payer explanation of benefits
- Billing for Medicare, Medicaid, Government, Commercial and/or third party insurance, including but not limited to
- Research and identification of payer guidelines
- Timely Filing guidelines
- Cash Posting
- Collections and Denials
- Appeals
- Variances/Refunds
- Payer portal usage
- GENERAL/ORGANIZATIONAL COMPETENCIES:
- Quality/Compliance: Achieves a standard of excellence with work processes and outcomes, honoring Organizational policies and all regulatory requirements.
- Customer focus: Strives for high customer satisfaction, going out of our way to be helpful and pleasant, making it as easy as possible on the patient, family member or customer rather than our department or organization.
- Safety Mindset: Promptly reports or corrects any unsafe condition. Records/reports the need for service maintenance or repair of equipment and removes any faulty equipment from service.
- Communication: Balances listening and talking, speaking and writing clearly and accurately, influencing others, keeping others informed.
- Collegiality: Is helpful, respectful, approachable and team oriented, building strong working relationships and a positive work environment.
- Initiative: Takes ownership of the work, doing what is needed without being asked, following through
- Efficiency: Plans, manages time well, is on time, is cost conscious, and thinks of better ways to do things.
- Coach-ability: Is receptive to feedback, demonstrates a willingness to learn, and embraces continuous improvement.
- Demonstrates an ability to work in a collaborative manner.
- Diversity: Acknowledges and respects cultural diversity in all interactions.
- Adaptability and flexibility to respond to a rapidly changing work environment
EXPERIENCE: Two years of experience preferred in any of the following: Medicare, Medicaid and/or Commercial Insurance billing, collections, payment and reimbursement verification and/or refunds. College education in business and/or accounting may substitute for experience on a year for year basis up to two years.
NATURE OF SUPERVISION:
Responsible to: Manager, Business Office
ENVIRONMENT:
-Bloodborne pathogen: A
Works in a clean, well-lighted smoke free environment.
PHYSICAL REQUIREMENTS: Long periods of sitting, walking. Must be flexible in work schedule. Subject to stressful situations. Extended use of video display terminal and keyboard utilizing sound ergonomic principles. May be required to push, pull or lift up to 20 pounds.
