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DEPARTMENT Public Health: CLOSING DATE 6/9/2024 11:59 PM Mountain Due to critical need the anticipated start date of this role will be 7/1/2024 or sooner. Please be advised this position may close on or after 5/28/2024, without advance notice, should we receive a sufficient number of qualified applications.

Collects and enters medical claim information into electronic health record system modules. Follows up with insurance companies and patients to ensure correct and accurate payment of services. Tracks managed care authorizations and limits of coverage.

Essential Duties/Responsibilities: -Creates insurance and patient aging reports using medical practice billing software, Excel, and PowerBI to identify unpaid insurance claims or patient accounts. -Responsible for timely and accurate insurance, lab, ad-hoc, and State reporting. -Updates and maintains patients Electronic Health Record; provides administrative support as needed. -Assists with enrolling new clients and verifying insurance coverage. -Obtains necessary pre-authorizations and ensures proper documentation and filing of authorizations. -Utilizes ICD 10 diagnosis and CPT treatment codes as well as traditional coding references. -Inputs information necessary for insurance claims and ensures claim information is complete and accurate. Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper CMS-1500 form. -Submits claims to all forms of insurance and follows up with insurance carriers on unpaid or rejected claims within required timeframes. -Leads the revenue cycle management process, including insurance verification, claims submission, claims management, and reporting. -Researches and resolves client billing problems or issues. -Documents payment records and issues as they occur. Posts payments within required timeframes and updates ledger in electronic health record. -Answers patient questions on patient responsible portions, copays, deductibles, write-off s, etc. Resolves patient complaints or explains why certain services are not covered. -Processes and follows up on payer denials, consulting with the patient and/or his or her family as needed. -Follows up with insurance company on unpaid or rejected claims. Resolves issues and re-submits claims. -Prepares appeal letters to insurance carrier when not in agreement with claim

denial. Collects necessary information to accompany appeal. -Prepares patient statements for charges not covered by insurance. Ensures statements are mailed on a regular basis as determined by the programs. Follows up on unpaid statements at regular intervals. -Works with patients and Financial Services Department to coordinate payments that patients file directly with their insurance company. -May work with patients to establish payment plan for past due accounts in accordance with provider policies. May perform soft collections for patient past due accounts. -Submits delinquent or past due accounts to a collections agency and provides necessary information to collection agencies for delinquent or past due accounts. -For patients with coverage by more than one insurer, prepares and submits secondary claims after processing by primary insurer. -Follows HIPAA guidelines in handling patient information. - Tracks managed care authorizations and limits to coverage. -Ensures all insurance and client payments are deposited into appropriate program accounts daily. -Participates in departmental emergency planning and response activities.

Knowledge, Skills, and Abilities: -Familiarity with electronic health record and software systems necessary for billing, payment, and report management. -Experience logging and applying payments and the ability to conduct thorough Accounts Receivable follow-up. -Knowledgeable on insurance and reimbursement process. -Ability to read and understand explanation of benefits (EOB) statements. -Stron knowledge of medical ICD-10 codes and CPT medical billing codes. -Strong knowledge of insurance claims processing and claims resolution. -Familiarity with HIPAA privacy requirements for patient information. Ability to maintain the security of sensitive and confidential information. -Ability to work with a high level of detail. Skilled in writing and maintaining accurate records and reports to meet management objectives. -Excellent verbal and written communication skills; excellent telephone and customer service skills. -Ability to work independently and in a team environment. -Ability to assess situations and make prudent and appropriate decisions; ability to apply conflict resolution and problem-solving skills. -Ability to perform under pressure and when confronted with persons acting under stress. -Ability to work in a fast-paced environment, manage multiple tasks, reprioritize as work situations change, and meet all required deadlines. -Must possess the ability to use standard office equipment, including telephone, computer, fax machine, and copier. -Proficiency in Microsoft Office, to include Word, Excel, and Outlook

See full job description here: https://www.governmentjobs.com/careers/elpasocountyco/jobs/451955 8/medical-billing-specialist-part-time?page=2&pagetype=jobOpportunitiesJobs