JOB SUMMARY:

The PartTime Insurance Billing Clerk assumes responsibility for maintaining a relationship with the patient and insurance carrier or a managed care organization. Working under the Practice Manager, the Billing Clerk will understand all aspects of the patient s insurance coverage, be aware of the paperwork, referrals, pre-authorizations/ pre-certifications to provide necessary care to the patient and will develop relationships with all manages care organizations and their case managers. Supports three Pediatric offices with fourteen providers

Qualifications:

Required:

• High School Diploma
• Candidate must be comfortable with heavy incoming and outgoing call volume,
• Previous medical billing experience
• Knowledge of computer programs

Preferred:

• Epic Resolute Billing experience
• Pediatric experience

Essential Functions:

• Knowledge of computer programs.
• Successful completion of all required orientation programs.
• Knowledge of guarantor accounts and pediatric requirements.
• Reviews ICD-10-CM coding performed by employed providers and/or affiliate staff for accuracy and completeness.
• Reviews HCPCS/CPT coding performed by employed providers and/or affiliate staff for accuracy and completeness.
• Reviews Evaluation and Management (E/M) coding performed by employed providers and/or affiliate staff for accuracy and completeness.
• Works collaboratively with providers and affiliate staff to promote and ensure correct and compliant coding and billing practices.
• Works collaboratively with Physician Billing Educators providing audit results, coding references, and other materials associated with completed reviews of employed providers, including research, and associated research documentation.
• Prepares detailed reports of review activities.
• Maintains proper computer and written records of all review activity.
• Effectively communicates coding recommendations and reasoning to medical staff members and others.
• Performs regulatory coding research for Compliance Department and/or employed providers and affiliate staff.
• Performs physician RAC coding reviews and prepares appeals when warranted.
• Assists internal and external Compliance counsel in external agency investigations as required.
• Corresponds with AMA, etc. with coding questions as necessary.
• Follow up with coding and RVU s of patients seen in the MMC nursery.
• Communicating with provider on outstanding charts.
• Reconciling errors in assigned WQ s.
• Review and follow all assigned PB and HB charge reports.
• Any other duties as assigned by the Practice Manager.

Benefits and Perks

At RWJBarnabas Health, our market-competitive Total Rewards package provides comprehensive benefits and resources to support our employees physical, emotional, social, and financial health.

• Paid Time Off (PTO)
• Medical and Prescription Drug Insurance
• Dental and Vision Insurance
• Retirement Plans
• Short & Long Term Disability
• Life & Accidental Death Insurance
• Tuition Reimbursement
• Health Care/Dependent Care Flexible Spending Accounts
• Wellness Programs
• Voluntary Benefits (e.g., Pet Insurance)
• Discounts Through our Partners such as NJ Devils, NJ PAC, Verizon, and more!

Choosing RWJBarnabas Health!

RWJBarnabas Health is the premier health care destination providing patient-centered,

high-quality academic medicine in a compassionate and equitable manner, while delivering

a best-in-class work experience to every member of the team. We honor and appreciate the privilege of creating and sustaining healthier communities, one person and one community at a time. As the leading academic health system in New Jersey, we advance innovative strategies in high-quality patient care, education, and research to address both the clinical and social determinants of health.

RWJBarnabas Health aims to truly make a unique impact in local communities throughout New Jersey. From vastly improving the health of local residents to creating educational and career opportunities, this combination greatly benefits the state. We understand the growing and evolving needs of residents in New Jersey whether that be enhancing the coordination for treating complex health conditions or improving community health through local programs and education.

Equal Opportunity Employer