Description

Job Purpose: Answer call from physician offices, hospitals, and patients using exemplary customer service skills.

JOB FUNCTIONS:

Essential Duties & Responsibilities

• Ensures that insurance information is correct in the billing fields.
•  Reviews insurance to determine if the payer is a split bill (both professional fees and facility fee bill).
• Creates the facility bill to reflect the appropriate CPT code when the bill is for a Medicare patient.
• Reviews the codes assigned in thee-bills by the coding and/or medical staff.
• Reviews for correct place of service.
• Reviews e-bill to determine if modifier assignment is warranted.
• Reviews the patient chart to ensure the patient is not in a global for a prior procedure.
• Creates a new e-bill for the facility bill form codes assigned on the professional e-bill.
• Ensure the evaluation and management category assigned is correct in respect to a new patient or established patient.
• Reviews for injections coded, looking for a J code attached to the administration CPT.
• Ensures the PQRS questions are answered prior to processing the bill.
• Creates to-dos to physician teams for clarification of issues identified.
• Reviews for fracture care - global or not.
• Scans various documentation for the department.
• Other duties as assigned

Requirements

QUALIFICATIONS:

Knowledge:

Education/ Training

• High School Diploma or GED.

Skills & Abilities:

• Fast paced environment, ability to work cases added at the end of the day.
• Knowledge of medical billing/collection practices.
• Knowledge of computer programs.
• Knowledge of business office procedures.
• Knowledge of basic medical coding and third-party operating procedures and practices.
• Ability to operate a computer and basic office equipment.
• Ability to operate a multi-line telephone system.
• Skill in answering a telephone in a pleasant and helpful manner.
• Ability to read, understand and follow oral and written instructions.
• Ability to establish and maintain effective working relationships with patients, employees and the public.
• Must be well organized and detail oriented.

Computer literacy:

• Must have working knowledge of network and PC operating systems.

Certificates/Licenses/Registrations

• NIA

Driving Requirements:

• A valid State of Georgia Driver's License and reliable transportation is required.

SPECIAL REQUIREMENTS:

Physical Demands: Requires sitting and standing associated with a normal office environment. Manual dexterity needed for using a calculator and computer keyboard.

Work Environment: Normal office environment. Occasional overtime may be required and/or hours may be shortened as business needs dictate.

DISCLAIMER: This job description is not intended to be all-inclusive; therefore, management has the right to assign or reassign schedules, duties and responsibilities to this job at any time, as business requirements dictate. It is mutually agreed that this job description does not constitute a written or implied contract of employment.

Georgia Urology is an EOE and provides a Drug Free Workplace