To execute ancillary services and Medicare consolidation billing process including, but not limited to, contract verification, updating of patient charges within specific payer guidelines to ensure accuracy and completeness for Imaging/ Lab, Physician services, transportation product lines, Medicare and Medicaid denials.
- Research and review lab charges and Medicare/Medicaid denials; Auditing invoices and claims and identify discrepancies.
- Responsible for oversight, completion, and implementing of rules and regulations of Medicare Consolidated Billing to current processes.
- Analyze and interpret contracts and determines eligibility based of contracts, fee schedules, UCR, and reconcile discrepancies.
- Create and maintain contracts in a database.
- Utilizes electronic health records (EHR) to review clinical audit documentation to determine if charges are valid and coordinate with facility for resolution.
- Partners with Accounts Payable (AP) to determine payment history, current invoices, and monthly balances.
- Perform routine audits of new contracts and A/P invoices and identify issues and escalate to supervisor as needed.
- Maintain files and documentation thoroughly and accurately, in accordance with company policy and accepted accounting practices
- Provide supporting documentation for audits as needed and requested.
- Track authorizations for services when appropriate for third party billing.
- Manage and maintain email inbox and attempts to resolve questions, invoices, and correspondences independently, or routes to the appropriate team member.
- Develop historical reports and year-to-date payment
- Detail oriented and has the ability to problem solve and multi - task in a fast - paced billing/audit environment.
- Excellent professional verbal and written communication skills as well as excellent keyboard skills.
- Professional attitude & reliable work ethic
- Strong problem solving skills,, including but not limited to basic accounting principles knowledge, documentation, research and resolution and data analysis skills.
- Ability to perform mathematical computations such as percentages, fractions, addition, subtraction, multiplication and division quickly and accurately
This position is an individual contributor and does not manage/supervise other employees.
This job operates in an office environment. This role routinely uses office equipment such as telephone, computer, printer, fax/scanner/copier.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is occasionally/frequently/continuously required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms. Sensory abilities required by the job include close vision and hearing.
Position Type/Expected Hours of Work
This is a Full-time position, and business days and hours are Monday –Friday, hours as determined by supervisors. Longer hours, evenings and weekend work will be necessary occasionally.
This position requires up to 0% travel.
Required Education and Experience
- Associates degree
- 2-3 years accounts payable or general accounting experience
- Ability to type 45 WPM
- Previous medicare billing / AR experience is required.
- Thorough knowledge of CPT / ICD codes and modifiers, EOBs, payer fee schedules as well as a strong understanding of the entire medical billing process
Preferred Education and Experience
- Experience in the medical billing field is highly desired
- Advanced skills in Excel (Pivots and VLOOKUPs)
- A strategic-minded, entrepreneurial thought process that allows you to see the big picture and solve problems accordingly
- Medicare Consolidated Billing at least 1 year