Medical Billing

Posted

Job Type: Ministerial

Reports to: Counseling Manager

Position Description

This part-time position collects and enters claim information, posts insurance and patient payments and manages accounts, submits claims and follows up with insurance carriers on unpaid or rejected claims, and answers patient inquiries on account status and charges.

As a ministerial representative of CCEOK it is expected that both professional and social behavior be aligned with the ethical and moral standards of the Catholic Church.

Tasks

  • Pray daily for the needs of the poor; opportunities include personal prayer, daily Mass, and/or adoration
  • Enters information necessary for insurance claims such as patient, insurance ID, diagnosis and treatment codes and modifiers, and provider information; Insures claim information is complete and accurate
  • Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper CMS-1500 form
  • Answer patient questions on patient responsible portions, copays, deductibles, write-off’s, etc.; Resolves patient complaints or explains why certain services are not covered
  • Follows up with insurance company on unpaid or rejected claims; Resolves issue and re-submits claims
  • Prepares appeal letters to insurance carrier when not in agreement with claim denial; Collect necessary information to accompany appeal
  • Prepares patient statements for charges not covered by insurance; Insures statements are mailed on a regular basis
  • Works with patients to establish payment plan for past due accounts in accordance with provider policies
  • Posts insurance and patient payments using medical claim billing software
  • Performs “soft” collections for patient past due accounts. This may include contacting and notifying patients via phone or mail
  • For patients with coverage by more than one insurer, prepares and submits secondary claims upon processing by primary insurer
  • Follows HIPAA guidelines in handling patient information
  • Periodically creates insurance or patient aging reports using the medical practice billing software to identify unpaid insurance claims or patient accounts
  • Understands managed care authorizations and limits to coverage such as the number of visits
  • Verifies patient benefits eligibility and coverage
  • Duties as assigned

Education Requirements

  • High School Diploma or GED
  • Medical Billing certificate

Skills

  • Knowledgeable on insurance and reimbursement process
  • Good math and data entry (typing) skills
  • Exercises good judgement and discretion
  • Familiarity with HIPAA privacy requirements for patient information Maintains and protects confidential information
  • Good verbal and written communication skills
  • Basic understanding of medical ICD 9 codes and CPT medical billing codes
  • Good telephone and patient relation skills
  • PC literate with PowerPoint, Word, Outlook

Attributes

  • Commitment to the mission and vision of Catholic Charities
  • Willingness to learn how to articulate Catholic teaching with a commitment to its application in the job function
  • Detail oriented, organized and ability to prioritize work
  • Self-motivated and self-starter
  • Team player, and able to work on own initiative
  • Professional and positive approach