Description

ORGANIZATIONAL UNIT: Health Services Department: Business Office

SUPERVISOR: Business Office Manager

FLSA: Non-Exempt

SALARY RANGE: $12.00-$23.00

ALL FULL TIME POSITIONS:     In addition to your pay, your salary also includes Medical, Dental and Vision Insurance. The Biweekly deduction from employee paycheck is $40.00 for Employee Only, $95.00 Employee plus Children, $120.00 Employee plus Spouse, and $140.00 Employee plus family.   

CPN Health Services personnel may be assigned to provide services to patients of all ages including but not limited to Indian Children and will require a criminal history background screening.

JOB SUMMARY:  Responsible for assisting with all aspects of third party billing and claim follow up. 

ESSENTIAL FUNCTIONS:

· Enters charges and procedures into the computer billing system and reviews diagnoses and links procedures with appropriate diagnoses.

· Prepares and submits third party claims to respective carriers on a weekly basis.

· Performs billing and A/R quality assurance duties as needed. Performs audits of documentation for appropriate E&M coding as needed and reviews audit findings with medical staff.

· Accurately codes and enters diagnoses and procedures in computer in a timely manner using appropriate ICD-9 and CPT codes.

· Reviews superbill forms for accurate completion by medical staff and returns forms to staff for correction.

· Assures appropriate documentation for diagnoses and procedures by reviewing documentation from random patient visits. Works closely with medical staff.

· Performs periodic quality assurance activities for coding.

· Assists in entering and maintaining current, accurate patient demographic and billing information in the computer.

· Assists with claim follow-up.

· Retrieves reports and statistical data as needed from the RPMS-PCC program.

ADDITIONAL DUTIES:

· Perform other duties and projects as required by management.

MINIMUM QUALIFICATIONS FOR CONSIDERATION: 

· High School Diploma or equivalent required.

· Experience with medical terminology, CPT, and ICD-9 codes.

· Two (2) years experience in third party billing and collections in a medical facility.

KNOWLEDGE, SKILLS AND ABILITIES: 

· Accurate typing/data entry skills.

· Must have good organizational skills and be able to work independently.

· Computer experience required.

· The ability to communicate effectively and accurately with providers, patients, third party reimbursement sources, and other staff.

· Required to abide by confidentiality policy.

· Knowledge of RPMS a plus.

PHYSICAL REQUIREMENTS: 

· Prolonged sitting or standing.

· Repetitive motion at a computer.

· Light lifting, stooping, and bending will be required.

· The ability to handle a large workload with demanding deadlines.

ENVIRONMENTAL CONDITIONS: 

· Health facility office environment.

Note: The above statements are intended to describe the general nature and level of work performed by an employee in this position. These statements are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of employees in this position.