Reports to the Site Manager. Under general supervision and in accordance with policies and procedures established by the BMG Central Billing Office, performs various routine and non-routine revenue cycle, billing, coding and insurance functions requiring exercise of initiative and judgment. Site Billing Representative III must meet the qualifications listed in the knowledge, skills and abilities area and be in a position working at a specialty, subspecialty or other designated clinic as designated by the Executive Director.
MISSION & VISION
Mission: To enhance the physical, mental and emotional well-being of the communities we serve as the community's provider of outstanding quality, superior value and comprehensive health care services.
Vision: Our vision is to achieve:
Innovative health care and well-being services of the highest quality at the greatest value
Easy access and convenience
Outstanding patient experiences
Ongoing education involving physicians, patients and the community
JOB SPECIFICATIONS
Education and Experience
The above level of knowledge, skills, and abilities are normally acquired through the completion of a High School diploma; Associate's degree preferred. Successful attainment of certification as a CPC (Certified Professional Coder), and maintenance of the certification is required. Strong knowledge of medical coding rules and regulations along with keeping current on issues regarding medical coding, compliance, and reimbursement is required. Knowledge and experience using medical billing software is required. One year of medical billing experience in a subspecialty field (i.e. cardiology, sports medicine, etc.) and /or two years of family medicine billing that would also include obstetrics and procedures are required. Required annually to complete a minimum of fifteen hours of continuing education towards maintenance of CPC and/or specialty field.
Knowledge & Skills
Requires knowledge of and ability to work with a multitude of insurance companies.
Requires ability to handle diverse work functions and multi-task projects with a variety of billing and insurance issues.
Requires strong math and accounting skills and analytical ability to properly make calculations, balance records, prepare reports, and apply computer concepts to billing practices.
Demonstrates specific knowledge of various third-party payor practices and procedures and CPT and ICD-9-CM coding in order to ensure that billings are accurately completed and in the proper format for efficient processing and payment.
Demonstrates well developed interpersonal and communication skills, both verbal and written, necessary to effectively deal with a diverse group of people and compose written communications using correct spelling, grammar, and format.
Requires knowledge of revenue cycle, computers, data entry, and spreadsheet software.
Working Conditions
Works in an office environment.
May experience some mental/visual fatigue from careful and constant review of records, code books, and continued use of computer equipment.
Physical Demands
Requires the physical ability and stamina to perform the essential functions of the position.