Medical Billing Clerk in Odessa, Texas at PermiaCare

Job Number: 168

Location: Odessa

Supervises: N

FLSA: Non-Exempt

Division: ADM

Salary: $15.66 per hour. Sign on bonus may be available.

Shift: M-F 8am - 5pm; Assignedwork hours may change as the needs of the agency and clients change

Driving required: Y

Travel required: Y

Settings: office

POSITION SUMMARY/JOB PURPOSE:

The Medical Billing Clerkreconciles payments received from third party payers with the AccountingDeposit Log, assists staff to maximize third party billings, and processes andsends monthly statements to clients. Thisposition investigates and resolves differences revealed from paymentreconciliation and identifies problems within the third party billing foraccurate coding, etc.

This position works independently,under limited supervision, reporting major activities through periodicmeetings.

EDUCATION, EXPERIENCE, OTHERQUALIFICATIONS:

Education Required: High School Diploma or GED.

Experience Required: At least 1 year experience in medical officeas third party biller preferred.

Registration, Certification,Licensure or other Qualifications Required:

• Must maintain a valid TexasDriver's license, auto liability insurance and a driving record acceptable toPermiaCare's insurance requirements.
• Required to pass criminal historyand background checks as well as pre-employment drug screen.

ESSENTIAL DUTIES ANDRESPONSIBILITIES:

• Download all third party 835payment files and EOB pdfs in the billing drive.
• Download third party DPP 835payment files in the DPP payment folder to allow processing by DPP PaymentProcessing folder. Upload all 835 filesincluding DPP 835 files in EHR for overnight processing.
• Post paper EOBs from third partypayers as they are received.
• Reconcile third party payments toAccounting deposit log.
• Analyze DPP payments amounts foraccuracy.
• Work ER claim file rejectionsand/or unposted 835 claims in EHR.
• Analyze and oversee all claimdenials, rejections and requests for more information from third party payers.
• Analyze and work denied claims onClaim MD and correct and reprocess and/or refile for corrected payment.
• Process and mail client statementsalong with the Insurance Verification Specialist monthly.
• Respond to phone calls related toclient statements, analyzing services that are being billed to the client aswell as the insurance company.
• Work with other clerks to correctclaim denials or rejections due to client coverage or eligibility issues, andresubmit for payment.
• Receive payment requests from IDDproviders which pertain to HCS billing for AA, DE, MHM.
• Meet unit performance measures ortargets.
• Enter accurate and appropriatedocumentation of services within timeframe required.
• Maintain confidentiality ofsensitive records and treatment information, client files and protected healthinformation in compliance with HIPAA, laws, rules and regulations, andestablished procedures.
• Maintain regular and reliablephysical on-site attendance. Regular attendance, dependability, and promptnessare required for the scheduled work day 100% of the time, to ensure consistencyand completeness of program's processes.
• Comply with the Abuse, Neglect,and Exploitation policy and reporting requirements.
• Adhere to the Code of Conduct andStandards of Behavior policy requirements.
• Establish and maintain effectivework relationships with individuals served and their families, supervisors,co-workers and visitors by demonstrating cooperative, courteous and respectfulbehavior at all times.
• Communicate regularly withsupervisor.
• Open and process mail/email in atimely manner.
• Answer phone, collect phonemessages and respond to requests timely and accurately.
• Maintain safe and clean workingenvironment by complying with procedures, rules and regulations.
• Perform all work functions andinteractions using a trauma informed approach.
• Display professionalism whenrepresenting PermiaCare and the program in the community.
• Maintain compliance with legalrequirements and company policies and procedures.
• Maintain valid and current driver'slicense, auto insurance, acceptable driving record and reliable transportationat all times. Driving may be required for this position.
• Complete all training as assignedprior to due date.
• Other duties as assigned.

MARGINAL DUTIES ANDRESPONSIBILITIES (these duties are not designated as essential for the purposesof ADA; they are still required duties):

• Fill in for other clerical staffas needed.
• Assist financial clerks with claimdenials or rejections of claims related to client eligibility issues as needed.
• Collect client credit cardpayments.
• Answer any questions clients mayhave about their statements and correct issues if needed in the EHR.
• Upload or assist supervisor withthird party claim submission into Claims Clearinghouse.
• Assist Reimbursement Supervisorwith provider credentialling.
• Provide translation, ifapplicable.
• Participate in team meeting orstaffings.
• Participate in communityactivities and/or attends community meetings as needed.
• Participate in workgroups andcommittees as assigned.

KNOWLEDGE, SKILLS, ABILITIES ANDCOMPETENCIES:

• Knowledge of spreadsheet formulasand data entry.
• Ability to accurately performdetailed reconciliation.
• Ability to investigate and resolvedifferences discovered during the reconciliation process.
• Ability to analyze clientstatements for discrepancies.
• Knowledge of EHR billing software.
• Knowledge of various insurancecompany portals.
• Ability to audit DPP payments.
• Knowledge of HIPAA and ability toprotect confidentiality.
• Effective multi-tasking skills.
• Good organizational skills.
• Welcoming, positive behavior.
• Ability to express self clearlyand effectively, orally and in writing.
• Effective time management skills.
• Exceptional customer serviceskills, including positive attitude.
• Cultural sensitivity.
• Dependable attendance andpunctuality.
• Knowledge of trauma informedtheories, principles and practices.
• Flexibility and adaptability todifferent work environments.
• Excellent computer skills,including Word, Excel, Outlook, and Electronic Health Records (EHR).
• Reading and comprehending.
• Reasoning and analyzing.
• Ability to coordinate with variousinter-agency personnel.
• Ability to fulfill PMAB andCPR/First Aid requirements.
• Ability to work independently.
• Good interpersonal skills,including ability to build rapport with individuals including co-workers.
• Ability to display comfort ininteracting with individuals of diverse cultural, ethnic and economicbackgrounds and with social service, healthcare, educational and criminaljustice organizations, as needed.
• Ability to acquire and utilize newskills as the job requires.
• Ability to work cooperatively andproductively with supervisor, individuals, co-workers, and groups of persons atall levels of activity, contributing to a spirit of teamwork.
• Ability to maintain highlyconfidential information.
• Ability to remain calm instressful situations.
• Ability to plan and schedule workand implement directives without constant supervision.
• Model professionalism byappropriate dress, language, ethics and work habits.
• Ability to drive personal and/orcompany vehicle. This position mayrequire travel to agency program sites, community and residential sites, and/orlocations outside the PermiaCare catchment area. This position may require transport of agencyindividuals and/or individuals served.

PHYSICAL REQUIREMENTS:

Abilities Required:

• Light Lifting, under 15 lbs
• Light Carrying, under 15 lbs
• Walking
• Standing
• Sitting
• Operating office equipment
• Operating motor vehicle
• Ability to see
• Hearing (with aid)
• Ability to write
• Ability to count
• Ability to read
• Ability to tell time

Other (specify): driving required. May require some travelafter hours and overnight.

WORKSITE CONDITIONS:

• Travel
• Inside
• Working closely with others
• Working alone

ADA Statement: Reasonable accommodations may be made toenable individuals with disabilities to perform essential functions.

EEO Statement: PermiaCare is committed to hiring andretaining a diverse workforce. We are proud to be an Equal OpportunityEmployer, making decisions without regard to race, color, ethnicity, nationalorigin, sex, sexual orientation, gender identity, religion, age, disability,veteran status, genetic information, or any other characteristic protected bystate or federal law.

This job description is notdesigned to cover or contain a comprehensive list of duties, activities orresponsibilities that are required of the employee for this job. Duties, activities and responsibilities maychange or new ones may be assigned at any time with or without notice. This jobdescription does not constitute an employment contract with PermiaCare. Employment is at-will.

#IN24