Billing Representative Home Care

Description

• High school graduate, Associate’s degree in business preferred, with further education in word processing, spread sheets and database management required. 

• Three years experience in a hospital or related prior employment required. 

• Proven above average math, analytical, interpersonal and communication skills required; medical terminology preferred.

• Demonstrated computer literacy with the ability to effectively learn a minimum of five computer programs.

• Experience with Blue Cross-Blue Shield, Medicare, Medicaid and other insurance coverage’s desirable.

• Demonstrated skill to effectively question public about sensitive issues, such as financial status, and communicate credit decisions to patients in a tactful manner.

• Proven ability to audit or verify written data for accuracy. 

• Demonstrated keyboarding of a minimum of 40 wpm with minimal errors required. 

• Meets Home Health and Medicare standards as evidenced by criminal background check and fingerprinting.

• Meets MHH established requirements for proof of health status. Physically able to lift 35 pounds. Demonstrates ability utilize good body mechanics or lifting techniques to avoid manipulating more than 35 pounds.

1. Supports the Mission, Vision and Values of Munson Home Health.

2. Embraces and supports the Performance Improvement philosophy of Munson Healthcare.

3. Promotes personal and patient safety.

4. Uses effective customer service/interpersonal skills at all times.

5. Contributes to the team orientation of the Billing Office area and is responsible for proper communication with all department members. Contributes to the team orientation of MHH and is responsible for proper communication between Billing Office and all other departments.

6. Responsible for "data accuracy and input" on the appropriate computer billing system.

7. Responsible for inputting new and updating old information on the computer billing system.

8. Handles questions from patients or interested persons concerning insurance, credit, or other problems relating to the agency.

9. Has authority to write accounts off to charity up to $500.00 and refer accounts to a collection agency up to $500.00.

10. Records bad debt payments and provides information for collection agencies in order to facilitate collection.

11. Reviews and mails monthly statements on private pay, commercial, compensation and problem Blue Cross and Champus accounts. Files electronic claims when available. Follows-up litigation cases.

12. Utilizes current billing system to scan all necessary patient documents into the electronic medical record.

13. Follows up with Physicians and referral sources for documentation/authorization needed to bill for services.

14. Reviews Munson Home Medical Equipment accounts receivable statements, post comments, bills insurance, receives payment, coordinates refund, sends statements and makes collection calls. Refers uncollectibles to collection agency.

15. Files claims with Probate Court against deceased patients' estates.

16. Maintains the confidentiality of all information exposed to while an employee of Munson Home Health.

17. Organizes and leads/participates in interdepartmental meetings with emphasis on Continuous Quality Improvement process.

18. Keeps current with changing insurance benefits and coding, and share pertinent information with billing team members.

19. Verifies insurance benefits for Munson Home Medical Equipment and completes referral profile process including patient correspondence. 

20. Understands and complies with applicable written process and procedure manuals.

21. Backs up other positions as necessary.

22. Employees with e-mail are required to maintain proficiency in the basic functions of the program and are also required to regularly check email and keep calendars up to date.

23. Posts cash payments on a daily basis.

24. Performs general confirmation of work orders and sends certificate of medical necessity (CMN) when required.

25. Completes store deposit on a daily basis.

26. Complies with MHH and department policies, procedures and guidelines

27. Performs other job duties and responsibilities as assigned.