POSITION SUMMARY:
To be fully engaged in providing Quality/No Harm, Customer Experience, and Stewardship by: ensuring the financial integrity of Health First, Inc/HF Medical Management by preforming established financial processes that enable and expedite the billing and collections. This includes: Customer Service, billing claims according to Federal/State and Managed Care rules, regulations and compliance guidelines, patient account research and resolution, resolution of credits and issuance of refunds, identification of payment variances invoices, follow up and resolution of denied claims
*PRIMARY ACCOUNTABILITIES: *
*Quality/No Harm: *
Proficient knowledge of business office applications to include Microsoft Word and Excel as well as other standard office equipment.
Demonstrates knowledge of and supports the organizations mission, vision, and value statement.
Completes work within authorized time to ensure compliance with department standards.
Maintains established benchmarks as related to assigned tasks and shows continual growth and improvement in benchmarks.
Apply Federal/State/Industry standard guidelines in order to resolve claim issues as approved by departments.
Secure needed medical documentation required/requested by payers.
Maintain clean and organized work environment.
Able to respond positively to stressful situations.
Ability to apply logic, common sense and identify solutions to complex problems.
Ability to prioritize work and manage time efficiently.
Ability to work independently throughout the systems to access and update information as needed.
Constructively participates in achieving departmental goals.
Constructively participates in the team Gallup Action Plan.
Assists with training new staff on department specific procedures and applications.
Demonstrate ability to accept responsibility for all aspects of job performance and departmental success.
Customer Experience:
Demonstrates in depth communication and problem-solving skills
Positively and professionally interact with customers and associates
Effectively coach/educate team members to improve quality
Maintains confidentiality regarding all aspects of operations
Stewardship:
Processes assigned accounts timely and maintains quality standards as set by the department.
Makes necessary calls to responsible parties/insurance companies for account resolution and properly documents actions within account receivable system.
Demonstrate the ability for the on-going analysis of processes to identify opportunities and make suggestions for improvement.
Review and processes accounts from various department assigned reports.
Recognizes trends and escalates issues to management.
Performs other duties as assigned by management.
*QUALIFICATIONS REQUIRED: *
High School Diploma required.
Associates Degree preferred.
Two years' progressive experience in Healthcare Billing, AR Follow-up, or related field required.
Excellent verbal, written communication and, problem solving skills required.
Thorough knowledge of medical terminology.
Thorough knowledge of coding (ICD-9, ICD-10, CPT and HCPCS).
Thorough knowledge of State and Federal programs, and managed care contracts.
Thorough knowledge of accounting principles preferred.
Computer experience required. Proficient in standard Microsoft Windows applications.
*PHYSICAL DEMANDS: *
Ability to sit at a computer for extended periods of time.
Ability to Multi-task.
Ability to work extended hours to ensure issue resolution.
Ability to enter data using hand/wrist dexterity.
*MENTAL DEMANDS: *
Demonstrate good observation skills and provide possible solutions to issues.
Ability to work independently.
Ability to manage multiple priorities.
Ability to maintain composure in and often stressful environment.
Job:
* Medical Billing
Organization:
* Health First Medical Group LLC
Title:
HFMG Revenue Cycle Specialist II - Patient Business Services
Location:
Florida - Brevard County-Rockledge
Requisition ID:
073492
