Primary Purpose

　　Primary purpose of this position is to support the New Bern and Havelock locations to review, analyze and code diagnostic and procedural information that determines Medicaid, Medicare and private insurance payments by ensuring ICD 10, CPT and HCPCS coding is correct.

　　Essential Functions

　　75%BILLING AND COLLECTIONS

　　Analyze New Bern and Havelock location insurance denials and resolve problems or discrepancies as they occur.Understand clinical information, and navigate through medical systems, billing, and ongoing communication with multiple insurance carriers, follow-up, denials, appeals, and collections.Prompt and thorough follow-up of accounts to obtain payment or final disposition of claims.All payments either insurance or first-party pay are keyed to the ledger daily.Collect outstanding debts either through the normal billing process or by utilizing the Countys Debt Set-Off program currently in place.Keep informed of updated fee scales as published by the Health Department and other agencies, along with private provider updates for filing of claims.Upon receiving the Electronic Funds Transfer (EFT) payment notification, access the appropriate system and print payment reports to be coded to appropriate earned clinical revenue accounts.Runs reports weekly to post all EFT payments to patient ledgers.Reconcile insurance remittance advice to verify the accuracy of keying to ensure that all procedures are correctly billed.Process refund requests as needed.Ensure that insurance balances are adjudicated within 90 days from the visit date.Receives bad check notices.Applies bad check charge to patients ledger.Follow up with the patient to have the bad check redeemed and the additional charge paid.20%REPORTS

　　Responsible party report helps to identify those patients who have responsibility for the patient's account balance.Report frequency will be determined by the Debt Set-Off coordinator and Administrative Officer Outstanding Medicaid, Insurance, and Occupational Medicine report to be completed monthly for both New Bern and Havelock locations.Prepare monthly earned Medicaid statistical report for the Health Director.This report is used by the Health Director to analyze and redirect revenue projections to the appropriate clinical programs.Responsible for running and analyzing outstanding Medicaid, Medicare, Commercial Insurance, and Credit Card usage reports.5%OTHER

　　Provide backup to Accounting Technician III and other positions within the billing department at both locations.Key daily visit charges, collect patient payments, review outstanding balances, and verify dates of service.Verify patients income and documentation.Other duties as assigned by supervisor(s) and/or management.In the event of a disaster, may be required to assist as needed.Minimum Education and Experience

　　Thorough understanding of medical billing with an understanding of claims analysis, collections, payment posting, revenue cycles, third party payers, Medicare and Medicaid regulations.Must possess excellent communication skills, including the tact required to counsel patients on financial responsibility.Ability to work with the public and co-workers, good telephone skills, knowledge of personal computer and software programs.Solid understanding and knowledge of ICD-10, CPT and HCPCS coding requirements for insurance claims.Ability to read, analyze, interpret complex insurance claims, verify documents and forms for accuracy and completeness.Must be organized and detail oriented.Proficient in Microsoft Office products and also have some working knowledge of an EMR.```{=html}

　　```- Graduation from a high school including or supplemented by basic courses in bookkeeping or accounting and three years' experience in bookkeeping or accounting clerical work in an accounting office; or- An equivalent combination of education and experience.- Preferred one-year minimum experience in a routine medical office setting with prior billing experience dealing with Medicaid, Medicare and Private Insurance.- Certified Professional Coding certificate is highly desirable.