The purpose of this position is to ensure accurate, compliant, timely coding, billing and appropriate reimbursement for our medical professional services from various insurance payers and patients. Responsibilities include dropping claims in the missing slips bucket, working the hold and manager hold buckets, correct and timely collection of unpaid patient accounts, re-billing, adjustments and appeals. Work cooperatively as a team and demonstrate behaviors of trust and respect toward others including clinical staff, physicians, associates and management.

A. Assist the Benefit and Eligibility staff person in checking the upcoming schedule for patient coverage, collection amounts, and pending balances. Add alerts to patient’s charts regarding coverage and amount to collect. Call patients if balances are over $50 to try to collect or advise patients to come prepared to pay at the appointment. (Work from Phreesia dashboard five days in advance of the visit).

B. Prepare and submit clean claims to various insurance companies in accordance with specific payer guidelines and/or contract requirements. Pending claims to be found in the missing slips bucket. Location: Workflow Dashboard

C. Analyze and correct first-pass rejected claims for completeness and accuracy of information for second-pass clean claim submission. Claims to be worked are found in the Hold bucket and Manager Hold bucket.

D. Research and perform all primary and secondary billing claim status follow-up activities for assigned insurance plans.

E. Review, evaluate, and process all claim appeals through resubmission to insurance carriers with complete and accurate supporting documentation required.

F. Review Unpostable Dashboard: In the Practice column of the dashboard. Ex: No matching charge/patient, balance forward, and old date of service items. Location: Main Menu > Financials > Unpostables > Unpostables Dashboard

G. Research and recommend any customer account adjustments and/or write-offs to Manager based upon collectability of account with insurance carrier or patient.

H. Submit any refunds for approval and process if applicable. Refund patient’s late night and weekend deposits after any pending payments. Close any posting batches used to post transfers, adjustments, or refunds daily. Location: Main Menu > Financials > Payment Batches.

I. Zero Pay: Review closed charges that received a zero payment and were adjusted off, based on the primary insurer’s payment rules: appeal any claims that qualify.

J. Recognize and report claims problems, errors, and discrepancies to management in order to proactively identify and effectively resolve billing trends in a timely manner.

A. Education/Skills

· High School Diploma, or equivalent required

B. Experience

· At least three (3) years of experience in medical insurance claims billing and Family Medicine preferred.

· Proficient in MS Excel and Word.

· Experience with Athena desired.

C. Licenses, Registrations, or Certifications

· Coding training or certification preferred

Job Type: Full-time

Pay: $18.00 - $25.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Day shift
• Monday to Friday

Application Question(s):

• How many years of experience do you have in family medicine?
• Do you have Athena EMR experience?
• What hourly rate of pay are you requesting?

Ability to Relocate:

• San Antonio, TX 78251: Relocate before starting work (Required)

Work Location: In person