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JOB DESCRIPTION: Duties include submitting claims to proper agency, posting payments, and following up on claims. Prepares, maintains, and distributes various reports, records, requisitions, and other documents pertinent to the department's daily operations.
SUPERVISION: Directly supervised by Program Manager.
TYPICAL PHYSICAL DEMANDS: Requires intermittent sitting and standing; may require moving up to 25 pounds. Requires the use of office equipment such as; computer, telephone, calculator, scanner, and copier. Travel required.
DUTIES
ESSENTIAL FUNCTIONS:
- Enters customer and account data by inputting alphabetic and numeric information on keyboard or optical scanner according to screen format.
- Maintains data entry requirements by following data program techniques and procedures
- Receives, reviews, and prioritizes correspondence.
- Participates in educational and promotional activities as requested.
- Compiles, copy, and completes data for administrative reports, and other documents.
- Develops, maintains, and updates the department's filing system.
- Keeps moderately complex records, to assemble and organize data, and prepares reports from such records.
- Reviews and electronically transmits claims, closes the day, compiles and prints daily reports.
- Maintains a log of all electronically and hardcopy (paper) filed claims.
- Responsible for downloading and saving Invoice/Billing Authorization Reports
- Posts payments for Clinic's and Provider's claims to patient's account as per invoice reports.
- Runs receipts report to verify that all payments are posted by site and that the check amount reconciles with the computer total.
- Reviews and identifies claim billing errors, and answers any associated correspondence from the claim processing.
- Researches and resolves outstanding claims and payment issues for billing and resubmits claims accordingly as well as assists in initiating the reimbursement process if needed.
- Investigates all denied claims by billing error codes and acts accordingly in coordination with/and under direct supervision of Business Office Manager.
- Ability to view clinical data to fulfill responsibilities.
- Responsible to generate monthly reports for all payments received from services rendered by Center providers.
- Maintains customer confidence and protects operations by keeping information confidential, and adheres to HIPAA Regulations.
- Adhere to agency policy, procedures and the professional code of ethics.
- Maintains operations by following program policies and procedures.
- Contributes to team effort by accomplishing related results as needed.
- Participate in regular staff meetings, staff training programs, supervisory sessions, and accept the responsibility for aiding the development of positive team relationships as requested.
- Performs other duties as assigned.
KNOWLEDGE, SKILLS AND ABILITIES:
- Computer knowledge in (graphs, charts, spreadsheets, etc.).
- Knowledge in office management.
- Must possess basic knowledge of compliance and HIPAA.
- Ability to interpret, understand and carry out instructions and orders.
- Ability to accept supervision and direction.
- Ability to work effectively and professionally in a fast-paced environment.
- Knowledge of and ability to work and engage with the uninsured, under-served and under-represented populations.
QUALIFICATIONS
MINIMUM QUALIFICATIONS:
- Graduate from an accredited high school or GED graduate.
- Two years technical/vocational school in Business Administration or three years' experience in this field preferred.
- Bilingual in English and Spanish is preferred.
- Possess means of transportation.
- Valid Texas Driver's License and minimum liability insurance.
- Computer knowledge in (graphs, charts, spreadsheets, etc.).
ESSENTIAL FUNCTIONS:
- Enters customer and account data by inputting alphabetic and numeric information on keyboard or optical scanner according to screen format.
- Maintains data entry requirements by following data program techniques and procedures
- Receives, reviews, and prioritizes correspondence.
- Participates in educational and promotional activities as requested.
- Compiles, copy, and completes data for administrative reports, and other documents.
- Develops, maintains, and updates the department's filing system.
- Keeps moderately complex records, to assemble and organize data, and prepares reports from such records.
- Reviews and electronically transmits claims, closes the day, compiles and prints daily reports.
- Maintains a log of all electronically and hardcopy (paper) filed claims.
- Responsible for downloading and saving Invoice/Billing Authorization Reports
- Posts payments for Clinic's and Provider's claims to patient's account as per invoice reports.
- Runs receipts report to verify that all payments are posted by site and that the check amount reconciles with the computer total.
- Reviews and identifies claim billing errors, and answers any associated correspondence from the claim processing.
- Researches and resolves outstanding claims and payment issues for billing and resubmits claims accordingly as well as assists in initiating the reimbursement process if needed.
- Investigates all denied claims by billing error codes and acts accordingly in coordination with/and under direct supervision of Business Office Manager.
- Ability to view clinical data to fulfill responsibilities.
- Responsible to generate monthly reports for all payments received from services rendered by Center providers.
- Maintains customer confidence and protects operations by keeping information confidential, and adheres to HIPAA Regulations.
- Adhere to agency policy, procedures and the professional code of ethics.
- Maintains operations by following program policies and procedures.
- Contributes to team effort by accomplishing related results as needed.
- Participate in regular staff meetings, staff training programs, supervisory sessions, and accept the responsibility for aiding the development of positive team relationships as requested.
- Performs other duties as assigned.
