Essential Functions
Note: The essential duties and primary accountabilities below are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Incumbents may perform all or most of the primary accountabilities listed below. Specific tasks, responsibilities or competencies may be documented in the incumbent’s performance objectives as outlined by the incumbent’s immediate supervisor or manager.
1. Conducts monthly pre-billing review and data quality analysis to ensure that invoices delivered to customers and providers are accurate.
2. Regularly receives and processes client and provider adjustments to ensure month end invoices are correct.
3. Uses a variety of collection techniques and forms relationships with business clients to resolve payment issues and escalate collection efforts as necessary.
4. Submits specialty billing for PACE and Medicaid clients using EDI software portal, reconciles EOBs, denied claims and conducts accounts receivable follow-up.
5. Updates pricing on orders in system to ensure invoice accuracy for special items, agreements, substitutions, and unauthorized deliveries.
6. Functions as a key contact person for all billing data integrity matters for clients, vendors, and various internal departments.
Marginal or Additional Functions
1. Creates and develops reports to address management needs; analyzes information to identify issues and recommends process improvements as appropriate.
2. May manage special billing & collections projects.
3. Protects company’s intellectual property and the privacy of customers’ data
4. Performs other duties as assigned or apparent.
Supervisory and Managerial Responsibility
- This position does not have supervisory or managerial responsibilities.
Knowledge, Skills & Abilities
Education, Licensure or Certification:
- High school diploma or equivalent is required
• A bachelor’s degree in business or related field is preferred
• Medical billing and coding license is preferred
Work Experience or Related Experience:
- At least two years of billing analytical experience in which employee worked within a team environment is required.
• Experience in the healthcare or medical fields in which incumbents have gained an understanding of durable medical equipment is preferred.
Specialized Knowledge, Skills & Abilities:
• Proficient and accurate data-entry skills are required to record and manipulate data as previously described
• Strong interpersonal skills due to constant contact both internally and externally. Displays the ability to work within a team
• Ability to work with independently and displays good prioritization skills
• A high attention to detailed information is required to review and reconcile data
• Ability to read service level contracts and understand the fee schedule for client and vendors.
• The ability to maintain confidentiality of patient information and follow standard operating procedures with regard to patient data to ensure compliance with HIPPA is required
Equipment:
• Strong knowledge of business and communications software (MS Office) and web-based tools are required
• Excellent spreadsheet (Excel) experience is required
• Experience with DMETrack software of at least one year is preferred
Travel Requirements and Conditions
- There are no travel requirements for this position
Work Environment, Conditions and Demands
- Work is generally preformed in an office environment or remote setting in which there is only minimal exposure to unpleasant and/or hazardous working conditions.
Physical Requirements and Demands
Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described.
• Regular eye-hand coordination and manual dexterity is required to operate office equipment
Additional Position Information
- No additional information is applicable
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