Summary
The Billing Associate will support all billing and credentialing activities. They will coordinate and communicate with numerous parties (internal and external) including but not limited to patients, third-party payers, clinical teams, patient support staff, finance and Community Health Net’s third-party billing/ credentialing team.
Duties and Responsibilities
• Assists with patient entry and obtaining accurate data for processing claims on a timely basis.
• Provides follow-up on encounter completion and provider tasking.
• Supports all billing activities including coordination with the billing/ credentialing team on deposits, patient receipts, claim processing, encounter, and third-party payer information.
• Supports all credentialing activities including coordination with the billing/ credentialing team and completion of necessary credentialing information for the third-party payers.
• Provides patient support services in accordance with best practices and in support of CHN’s mission.
• Identifies outstanding denial/ payer issues and coordinates resolution with appropriate parties.
• Provides follow-up on outstanding accounts receivable and collection duties as necessary.
• Participation in recurring meetings with the billing/ credentialing team, including coordination and resolution of outstanding items.
• Coordinates reporting needs for the billing/ credentialing team and other parties as necessary.
• Supports the reporting and reconciliation of the Medicare credit balances and the DHS wraparound reports.
• Provides productivity data and reporting as requested.
• Use computers for various applications, such as database management, word and spreadsheet processing.
• Collaborates with operational/ clinical staff on training as necessary on various topics including but not limited to registration/ demographics, encounter completion, Sliding Fee Discount Program, Migrant Farmworker program, Ryan White and Healthcare for Homeless billing.
• Provides coverage for other Finance duties as necessary.
• Perform other job duties as assigned.
Requirements/Qualifications
- High school diploma (or GED equivalent) with two (2) years applicable experience or Associate/ Bachelor’s degree.
- Certification in Billing and Coding preferred.
- Knowledge of word processing and spreadsheet software (i.e. Microsoft Office).
- Demonstrated ability to create reports and spreadsheets.
- Demonstrated ability to respond to inquiries in a tactful and courteous manner.
- Demonstrated ability to perform duties independently with minimal supervision and to exercise proper judgment.
- Understanding of clinical terminology is required.