Billing Spec in Sanford, NC at Central Carolina Hospital

Date Posted: 6/13/2020

Job Snapshot

Job Description

Central Carolina Hospital

Summary: 
The Billing Coordinator (“BC”) is the “central hub” of the LPNT/PMDS/Athena operating model. This resource is the primary metrics manager and process improver across all practices and groups.
Over the course of any given week or month, the BC may interface with LPNT and/or PMDS Leaders to receive guidance/direction/prioritization of duties. The BC will also work with practices, Providers and Staff to enact changes, develop new processes and coach/train individuals to adopt best practices.
It is our strong suggestion that the final Billing Coordinator candidate be an individual who has a proven track record for learning/growth, for process/performance improvement, and for positive communication/change management in the revenue cycle.

Essential Duties:
1. Claim Worklists
•Monitor volume and outflow in all claim worklists, following up with specific practices and individuals to understand the root cause of claim buildup
•Assist front office and coding staff with workflow questions related to their respective claim holds
•Take full ownership of the credentialing worklist and resolve holds by working directly with payers and contacting the HSC Enrollment Team as needed
•Contact the PMDS Team Lead to review holds that need to be reassigned to a different worklist
•Educate providers, front office staff, and coders on workflow corrections based on feedback from the PMDS Team Lead
2. Missing Slips, Coding and Charge Entry
•Monitor Missing Slips volume and follow up with providers who are not locking eCW encounters
•Ensure coders are dedicating allotted hours (see Staff Roles & Costs) to the Coding Worklist
•Ensure coders are manually entering out-of-office charges
3. Credentialing and Enrollment
•Before go-live: Work with Amanda Peaslee to complete “Enrollment Tasks” in Athena
•During go-live: Address outstanding pre-live tasks, and review the credentialing claim worklist to identify new tasks
•After go-live: Resolve claims from the credentialing claim worklist; submit PAD requests and complete credentialing tasks in Athena for new providers
4. Unpostables Dashboard
•Review all unpostable records deemed market responsibility per the “Unpostable and Correspondence Responsibilities” document
•Research payment and patient account errors preventing successful payment collection
•Resolve posting errors by updating account information, rerouting payments, and more
•Coordinate with individual clinics to ensure patient accounts are corrected as needed
5. Remittance Dashboard
•Manage co-mingled remittance files and upload to the appropriate EMR system
•Trace misrouted payments and coordinate with finance to allocate in appropriate bank account
•Provide missing remittance files and payment documentation to the Athena payment posting team (directly within the Remittance Dashboard)
6. Correspondence Dashboard
•Review all correspondence records deemed market responsibility per the “Unpostable and Correspondence Responsibilities” document
•Close records that do not require follow-up
•Contact payers and patients to resolve records that require additional information
•Reassign records to Athena, PMDS, or individual clinics if necessary
7. Payment Collection
•Post legacy payments to eCW and Simplee following the Athena go-live
•Assist front office teams with payment processing issues, and with payment collection during the Athena transition
8. Deposits
•Perform daily bank deposits for TOS and other cash received locally; or confirm that each clinic is depositing their own cash
•Coordinate with Finance to match deposit batches to bank activity each week via Financials>Reconcile Deposits to Bank Activity
•Confirm clinic cash drawers are balanced daily via Financials>TOS Money; follow up with individual clinics that are out-of-balance
9. Refund Management
•Review refunds initiated by the PMDS team on a weekly basis; transmit refund requests to the finance or Parallon team
•Confirm that refund checks are successfully processed and mailed
•Complete any additional forms or process points outside of the LPNT/PMDS standard


Job Requirements

Required Education:
Associates Degree required.

Other:
Must have at least two years of medical billing experience.

Equal opportunity and affirmative action employers and are looking for diversity in candidates for employment: Minority/Female/Disabled/Protected Veteran

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