The Role
Process, correct, and submit electronic medical claims; ensure accurate EMR documentation and coding; post payments, balance batches, enter cash receipts; resolve denials; collect patient balances; answer billing calls and coordinate with providers to ensure complete, correct claims.
Summary Generated by Built In
Job Summary & ResponsibilitiesPreferred Qualifications
SUMMARY OF JOB DUTIES:
The person handling this position is responsible for correcting, completing, and processing and collecting payment for claims of all payer codes.
ESSENTIAL JOB FUNCTIONS:
- Daily key punching into computer when needed to assure accuracy of billing for all services rendered in patients account to be completed within 24 business hours of the completed service.
- Ensure completion of documentation and coding on the EMR when needed on charges entered in patient's accounts for a correct and complete billing claim.
- Monthly input of all ancillary services including Nursing Home and Home Health charge encounters into the computer to assure accuracy of services rendered.
- Daily review of all postings before claim submission.
- Daily closing of batches and balancing of money posted.
- Enter cash receipts if needed and assure correct allocations, distribution in accordance with the established protocol.
- Responsible for submitting all electronic claims.
- Responsible for answering Billing Phone calls and providing exceptional customer service to patients with billing related questions.
- Resolving claim denials and issues with claim payment in a timely manner.
- Working to collect patient balances in a timely manner.
- Effectively communicate with providers on claim documentation for charges submitted.
Knowledge/Skills/Abilities:
- Ability to work under pressure.
- Ability to handle multi-functions/multi-tasks.
- Ability to problem solve.
- Pay attention to detail.
- Understanding of community-based organizations.
- Ability to communicate with the medical/dental staff and Office Managers.
- Some knowledge of bookkeeping and office functions.
- Some knowledge of CPT and ICD10 codes.
- Ability to work proficiently and efficiently on a timely manner.
- Knowledge of all payer codes.
- Knowledge of all programs offered by NHSI.
MINIMUM REQUIREMENTS
- High School Diploma or Equivalent
- CPC Certification required
- At least 3 years of billing and coding experience (outpatient/medical practice coding experience preferred)
- (2) Training or background in ICD-10 / CPT codes.
- Knowledge of medical terminology and billing practices.
Skills Required
- High School Diploma or Equivalent
- CPC Certification
- At least 3 years of billing and coding experience
- Outpatient/medical practice coding experience
- Training or background in ICD-10 / CPT codes
- Knowledge of medical terminology and billing practices
- Knowledge of all payer codes
- Knowledge of all programs offered by NHSI
- Ability to complete and code documentation in an EMR
- Experience submitting electronic claims
- Ability to post and reconcile payments, enter cash receipts
- Strong communication and customer service skills for billing inquiries
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The Company
What We Do
Complete Health is a leading privately owned, physician-driven, value-based primary care group headquartered in Jacksonville, FL. They provide exceptional senior-focused primary care across Alabama, Florida, and Colorado, with a mission to redefine physician practice for seniors by empowering providers to focus on patient care within a value-based care environment built specifically for the needs of seniors.
