Practice Account Specialist I

Description

JOB SUMMARY

Practice Account Specialist is a multi-skilled person trained to facilitate medical practice charge entry and other accounts receivable activity. Practice Account Specialist assists patients, Practice Manager, Practice Coordinator, physician* and clinical staff to ensure operational efficiencies related to charge entry or other account receivable activities. 

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Review all charge entry documents for complete information in preparation for entry into Context or Plus.
• Verify all necessary referral and authorization information is entered into system prior to charge entry.
• Verify and update demographics and insurance in the practice management system prior to charge entry or as needed.
• Post CPT-4, ICD-9-CM, ICD-10-CM and HCPCS codes by reviewing source documentation, coding policies and procedures and applicable carrier guidelines using Context or Plus, keeping a high level of accuracy.
• Key and release charges into the charge scrubbing system daily.
• Maintain a ‘check and balance’ system by comparing charges posted with the physician scheduled on a daily basis.
• Review and resolve context claim coding edits on a daily basis.
• Assist with the creation of Context rules for denial prevention as needed.
• Complete necessary paperwork for the creation of Context rules to aid in denial prevention.
• Resolve coding-related claim denials on a weekly basis.
• Communicate with physicians as needed to facilitate accurate coding and billing.
• Research coding issues and report to Practice Manager or VP of Operations.
• Resolve all outstanding items on the Missing Service Report (MSR) weekly.
• Collect all co-payments, deductibles and other monies owed at the time of service. Follow established protocol for receipt writing, cash collections, and nightly deposits.
• Attend all required training, coding seminars or monthly meetings as required.
• Complete deposit log at end of each day.
• Identify yourself to internal and external customers by wearing your identification badge at all times.
• Greet patients with courtesy and respect. Answer questions and direct requests appropriately and efficiently.
• Answer telephones promptly and in a professional manner according to MCC customer service standards.
• Operate computer within the guidelines of MCC.
• Comply with MCC policies as directed, carrier policies, and other protocols associated with the medical practice.
• Provide back up to the front office by functioning as a PSR III as needed.
• Other duties as assigned. 

CORPORATE CULTURE RESPONSIBILITIES 

• Follow established corporate and department-specific policies and procedures.
• Attend all corporate and department-specific required training.
• Uphold MCC’s Purpose, Values, and Vision.
• Abide by MCC’s Corporate Culture Responsibilities.
• Perform other duties as may be assigned cheerfully and willingly.

Requirements

EDUCATION/EXPERIENCE REQUIREMENTS

•  Minimum education requirement is high school diploma, or equivalent.
•  Completion of an approved medical coding curriculum or 1 years of recent coding experience. 

KNOWLEDGE, SKILLS AND ABILITIES

• Display customer services skills, strong interpersonal skills, close attention to detail, and excellent verbal and written communication skills.
• Be a person of integrity and character, willing to embrace change and make a positive impact in the lives of patients and co-workers.
• Ability to work with staff members at all levels of the organization in a cooperative, team-oriented manner.
• Displays computer proficiency (i.e. PC windows and MS Office environment) and ability to quickly learn new applications. Preferred ability of typing 40 cwpm.
• Proficient in use of English language both in written and verbal communication.
• Must be able to communicate with individuals of varying socio-economic backgrounds.
• Displays ability of giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
• Professional demeanor and recognition of privacy considerations for patients and families.
• Desire to advance coding skills/knowledge.
• Must possess high ethical standards in the field of medical coding.
• Must possess a basic understanding of the reimbursement process. 

PHYSICAL REQUIREMENTS OF THE ESSENTIAL JOB FUNCTIONS

• Strength (Lift/Carry/Push/Pull): Sedentary (exerting up to 10 pounds of force occasionally)
• Standing/Walking: Occasionally; activity exists up to 1/3 of the time
• Keyboarding/Dexterity: Frequently; activity exists from ¾ of the time
• Ability to look at a computer screen for extended periods.
• Ability to perform constant repetitive hands and finger motions.
• Ability to work in various positions (standing, sitting, bending, and walking) for extended periods of time.
• Ability to sit consistently during a minimum 8-hour workday.
• Talking (Must be able to effectively communicate verbally): Yes
• Seeing: Yes
• Hearing: Yes 

EMOTIONAL REQUIREMENTS OF THE ESSENTIAL JOB FUNCTIONS 

• Must exhibit stable work behaviors daily.
• Must possess adequate individual coping skills.
• Ability to remain calm and professional regardless of workload or time constraints.
• Must be able to work under stress and remain calm and professional. 

WORK ENVIRONMENT 

• Clinical office environment.
• Exposed to frequent and constant interruptions in daily functions/schedule.
• Must be available to customers and staff throughout the day.
• May be required to work extended hours to meet department needs.