Billing and Collections Specialist, RMF Revenue Cycle

Billing and Collections Specialist, RMF Revenue Cycle - 22064

US:

TX:

Edinburg | Financial Services | Full Time

DHR Health - US:

TX:

Edinburg - Days

Summary:

MISSION STATEMENT:

Our Mission is to improve the well-being of those we serve with a commitment to excellence: every patient, every encounter, every time.

VISION:

Our Vision is to create a world-class health system to advance medicine and increase access for the communities we serve by empowering caregivers to heal through compassion, knowledge, innovation, integrated care and excellence.

POSITION SUMMARY:

This position is responsible for business office activities which include collection of accounts receivable, patient billing, customer service, cashiering, refunds/recoupments, appeals, and provides refunds for services to patients and third-party payers as needed. This position requires that at least three (3) of the functions above can be performed.

POSITION EDUCATION/

QUALIFICATIONS:

• High School Diploma/GED is required
  Comprehensive knowledge of healthcare reimbursement.
  Understands medical terminology
  Familiarity with EOB’s and RA’s
  Knowledge of Microsoft Office suite, working knowledge of Excel required.
  Excellent Customer Service
  Good written and verbal communication skills required
  Must be able to multi-task
  Ability to read, write and speak English
  Ability to communicate clearly and concisely with all levels of management
  Bilingual – English/Spanish, preferred
  Previous healthcare and hospital experience preferred.
  Ability to use the internet to obtain information from Third Party Payers or other sources is required.
  Requires working with minimal to moderate interruptions

JOB KNOWLEDGE/

EXPERIENCE:

• Previous healthcare and hospital experience preferred.
• Communicates clearly and concisely and is able to work effectively with other employees, patients and external parties
• Establishes and maintains long-term customer relationships, building rapport with other department staff
• Demonstrate proficiency in Microsoft Office applications, be able to type at least 35 WPM, and good working knowledge of Excel is required.
• Able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly and spell correctly.
• Medical Terminology, ICD – 10, Codes, CPT Codes, HCPCS code, Modifier knowledge required.
• Ability to use the internet to obtain information from Third Party Payers or other sources is required.
• Requires working with minimal to moderate interruptions
• Occasional evening or weekend work may be required

Responsibilities:

POSITION RESPONSIBILITES:

• Promotes the facility mission, vision and values by effectively communicating them to others. Considers mission, vision and values in developing services, standards and practices
• Staff are responsible for posting all charges within allowed time frame following HIPAA regulations, Data entry procedure, insurances policies and quality assurance procedures. Data entry staff are expected to post 100+ patients daily based on work assigned.
• Daily Deposit Summary Report Validation, (Needs the signature of the person completing the form and management)
• Daily reconciliation per batch, the reconciliation must match the total amount collected for the patients included in the batch, POA and PPS, and run all necessary reports.
• Follow Self-Pay reconciliation process.
• Follow patient eligibility department protocol.
• Follow all necessary rules to ensure all mandatory segments are included in the medical billing software to ensure clean claim submission. (authorization, patient’s demographics, patient IDs, units, NDCs, etc.)
• Update insurance information based on insurance cards provided in the billing batch.
• Confirm CPT code indicated in the system queue matches medical record system orders. Variations should be…