Billing Coordinator I HHP at Jackson County Memorial Hospital Authority – Altus, Oklahoma

Job Summary: Under the direction of the Director, the Billing Coordinator is responsible for billing functions within Home Health Products. Tasks will include: order intake and preparation of necessary delivery documents for new orders, insurance verification and required prior authorization as needed, and computer entry. Verifies completeness of documents. Additional tasks may include other segments of the billing process depending on experience level, such as: confirmation of orders, electronic and paper submission of claims, posting payments, working insurance denials, and resolving issues and questions concerning billed claims and invoices.

Shift: 8:30 - 5:30

Demonstrates competency in the Following Areas:

All billing staff will perform the following tasks:

· Answers company telephone courteously and efficiently.

· Monitors billing office fax, distributing and preparing orders as necessary.

· Prepares delivery and pick up documents based upon telephone and faxed communication from referral sources.

· Conducts insurance verification and prior authorization as required for new orders.

· Responsible for regular processing of recurring supply orders, as divided by alphabetical division of patient base.

· Scans documents into the document imaging portion of the patient computer record as appropriate.

· Responds to billing questions and problems from patients and fellow employees.

· Performs miscellaneous duties according to staffing needs as requested by management.

· Follows up on past due accounts receivable for assigned accounts.

Duties assigned to order confirmation billing functions:

· Responsible for order confirmation process for all completed deliveries.

· Responsible for printing and monitoring the Open Orders report. Investigates and corrects any open order not completed within 3 days to keep open orders to a minimum. Prints report, notates status on each order, and turns in to the Assistant Director at month end.

· Responsible for correcting errors as listed on the confirmed orders for billing report, billing log exception reports, and other reports generated in the confirmation process.

· Prepares and mails follow up and brace closet patient satisfaction surveys.

· Prepares order intake, delivery documents, and pick up documents for CPM machines.

· Maintains communication and positive relationship with JCMH P.T. and nursing staff so that CPM machines are delivered in a timely manner and according to physician preference.

· Responsible for accurate equipment tracking records for CPM machines.

· Responsible for all necessary medical and billing documentation for CPM machines.

· Responsible for weekly preparation and distribution of the oxygen patient disaster list. Updates disaster map weekly.

· Generates scheduled transaction report for recurring product deliveries

· Prepares end of month open order report.

Duties assigned to the claims function:

· Prepares initial billing runs and corrects errors identified through billing runs. Completed in a timely manner.

· Prepares and tracks medical documentation such as Certificates of Medical Necessity, re-certifications, pre-authorization requests, and Written Confirmation of Verbal Order as required.

· Procures additional medical documentation for claims requiring the KX modifier, and as required by Medicare, Medicaid, and other insurers.

· Updates CPAP compliance option documents per Medicare regulations.

· Logs requested and received CMN’s and written orders in CMN database. Documents in patient files as appropriate.

· Prepares initial insurance claims and invoices. Bills patients, wholesale accounts, and insurance carriers in an accurate and timely manner.

· Responsible for electronic billing for Medicare, Medicaid, and third party carriers.

· Updates credit memos within the computer system.

· Prepares, records, and mails transfer of titles for rental equipment rented to purchase price.

· Identifies oxygen patients eligible for updated equipment. Insures that delivery documentation is prepared as needed.

· Prepares billing hold report. Tracks, identifies and corrects errors on report.

· Prepares and updates transaction edit reports.

· Links HCPCS records, insurance records, and physician records to expedite correct billing

Duties assigned to the cash posting/collections functions:

· Posts all money received to individual customer accounts and wholesale accounts in an accurate and timely manner.

· Verifies accuracy of posting and bank deposit by utilizing daily cash reports. Assists with balancing the cash register as needed to balance deposits.

· Prepares monthly deposit distribution listing to verify accuracy of posting and bank deposit. Forwards to company director in a timely and accurate manner.

· Researches claims rejected or denied by Medicare and other payers. Corrects errors for resubmission. Files for redeterminations and appeals as needed.

· Confers with insurance carriers, customers, and medical personnel as needed to resolve billing problems. Prepares business letters as needed.

· Researches incomplete and inaccurate payments, and denied claims. Corrects errors and resubmits.

· Responsible for collection procedures including collection letters, charity applications, payment agreements, and bad debt write off as appropriate.

· Tracks insurance denial codes.

· Verifies Physicians licensure.

· Researches Medicare and governmental regulations and laws so that company billing is performed accurately and according to applicable laws.

· Links HCPCS records, insurance records, and physician records to expedite correct billing

Demonstrates competency in the Following Areas:

· Assist with telephone and customer sales and service in the front of the store as necessitated by customer volume and staffing needs.

· Participates in semi-annual physical inventory.

· Maintains cleanliness of work area (vacuum, dust, and take out trash).

Professional Requirements:

· Meets dress code standards; appearance is neat and clean.

· Courteous to patients, caregivers, referral sources, customers, and fellow staff members, and company management.

· Completes annual education requirements.

· Maintains regulatory requirements.

· Wears identification while on duty.

· Attends annual Hospital and Department in-services as scheduled.

· Requires to show competence of the following:

o All form and all patient information

o All infection control and all safety

o Operation and management of oxygen concentrator and oxygen cylinder.

o Cleaning and storing equipment

o Telephone operation and procedures

o Cash register and credit card operation

o Computer operations

· Communicates the mission, ethics and goals of Home Health Products.

· Arrives on duty punctually, as scheduled, ready to begin and complete assigned tasks. Limited absences with timely notification of any illness or absence.

· Works in a spirit of genuine harmony with fellow workers. Works well with supervisor and supports his/her directives. Strives to maintain a good rapport and appropriate interdepartmental relationship with other hospital departments.

Education/Experience--All Positions:

· Associates Degree in business preferred.

· Typing speed of 35 wpm required. Must pass the “Office Ability” test as administered by the Human Resources Department with a score of 80% or better.

· One or two years of previous commercial business experience required. Previous experience with insurance and/or hospital medical equipment preferred. Previous work experience that demonstrates steady attendance and punctuality is required.

· Ability to deal with the public in a courteous manner. Must meet public and work well with elderly.

· Qualified individual will be given on-the-job training.

· Ability to read and communicate effectively in English.

· Additional languages preferred.

· Basic computer knowledge.

· Will have secretarial and receptionist skills.

Billing I

· Maintained working as a Biller or other Patient Accounting position within the organization for less than years.

· Basic knowledge of HME and claims processing.

· Basic knowledge of Microsoft Excel and Microsoft Word.

· Must be able to communicate (orally and in writing) effectively with patients, doctors, and other departments.