POSITION PURPOSE:
This position is responsible for prompt, accurate, and effective medical insurance claim submission, with follow-up of claims to satisfactory resolution.
ESSENTIAL FUNCTIONS:
- Review medical documentation and assess for proper coding utilizing CPT, HCPCS, and ICD10 coding materials, working closely with providers and other medical staff to ensure accuracy.
- Submit clean claims to all payer types for prompt return of accounts receivable.
- Follow-up on unpaid claims and resolve any billing issues in a timely manner.
- Stay current on coding and billing guidelines for all payer types, to include commercial, government, and worker’s compensation.
- Identify accounts which may require a refund and process appropriately.
- Manage claims through various online tools and reporting systems.
- Identify education needs for providers and medical staff based on coding assessments and/or updates, and act accordingly.
- Assist patients with billing questions and issues, to include guidance on office policies regarding sliding scale discounts and payment arrangements for outstanding balances.
- Post payments in practice management system, maintain batch controls and run reports appropriately.
- Assist front office staff with billing questions relating to proper registration and scheduling of appointments as needed.
- Participate in projects, trainings, and office/staff meetings.
- Follow all Aviva Health policies and procedures.
QUALIFICATIONS:
- High School Diploma or GED required.
- Minimum of one year experience in medical billing utilizing ICD-10, CPT, and HCPCS coding.
- Excellent written and oral communication skills.
- Certification in medical coding/billing preferred.
WORKING CONDITIONS:
Must be able to perform the following physical requirements:
- Remain in a stationary position frequently throughout the day while performing duties.
- Move or traverse occasionally throughout the day throughout the worksite.
- Operate equipment frequently throughout the day: computer, phone, printer, standard office equipment.
- Ability to communicate information and ideas clearly and accurately so others will understand; ability to interact with patients and staff clearly.
- Able to move or transport up to 5 pounds while transporting laptop computer.
- Work on-site indoors in heat-controlled environment frequently throughout the day.
- OSHA Exposure Category – Category #2: The normal work routine involves no exposure to blood, body fluids, or tissues.
- Onsite work in office.
- Normal business hours.
- If employee becomes eligible to work remotely, periodic travel to the office for work is required and a remote work agreement and regular home office safety inspections are required.
DISCLAIMER:
Employees must be able to perform the essential functions of their position satisfactorily. Aviva Health will make reasonable efforts to accommodate a qualified applicant or employee with a known disability unless such accommodation creates an undue hardship on the operation of the business. To request a reasonable accommodation, please contact the Human Resources Director or their designee by email.