Job Details

• Verify contractual write offs in PAS, then submit claims to electronic clearing house.
• Upload claims to electronic clearing house and work any upfront rejections.
• Back up to the Payment Posting Department.

Required Skills Required Experience

• EXPERIENCE

  • Two years previous experience in Ambulatory or Hospital billing, payment posting preferred. Computer experience required
  • Must have the skills necessary to operate the office equipment required to fulfill job duties
  • Forty-five (45) wpm typing skills
  • Medical terminology and computer experience beneficial
  • Knowledge of CPT and ICD-10 codes

• ADVANTX PROCEDURES

  • Ability to interact with team members, management and facility
  • Knowledge of procedures for Refund checks
  • Knowledge of Advantx registration, billing transaction modules.
  • Knowledge of billing /payment posting procedures
  • Knowledge of facility Managed Care Contracts
  • Knowledge of required detailed accurate information policies and procedures
  • Notify Facility and/or Management of any discrepancies
  • Scan documents for non-Scan Chart facilities daily to shared drive
  • Submits paper and electronic claims daily
  • Understands all areas covered in Registration/Case History
  • Understanding and basic knowledge of CPT and ICD.10 codes
  • Verifies data for accuracy
  • Verifies proper Managed Care Plan and contract allowable
  • Works with teammates to ensure all deadlines are met

• SCAN CHART

  • Ability to research documents through patient search, schedule, payments, and charge entry
  • Knowledge of billing procedures

• MONTH END

  • Ensures all cases have been billed.
  • Ensures all prepayments are posted to accounts after give the open for new business email. (Run a self-pay aging by carrier to ensure all balance have been transferred to patient). When necessary back-up payment posting
  • Run required Advantx reports for assurance all cases are complete and give to Management. (appt. billing analysis, cases by surgeon(1 performed and 1 pending), insurance payment analysis)
  • Reports any discrepancies to Manager

• WAYSTAR

  • Efficient with payer/name matching
  • Ensure batches are up loaded and accepted by Waystar
  • Submits claims daily through Waystar
  • Waystar rejections are worked daily