Charge Entry Billing Coordinator
New Season

Job Info

---

CHARGE ENTRY BILLING COORDINATOR

Job Summary:

This position adjudicates the daily/weekly/monthly procurement of outbound claims to health plans. As part of this role, steps are taken to assure that unbilled claims are moved into a billed status and those claims are both HIPAA-compliant and accurate, fairly representing the service provided by the organization. This role also identifies routine errors on claim forms referring same to management for action.

Essential Functions:

• Observe and respond to all requests of data analysis to correctly pass through clearinghouse systems for transmission of the claim to the health plan.

• Prepare claim data for the organization's Audit Worksheet on a weekly basis using current methods.

• Prepare and maintain claim output for grant funding and other contracted coverage sources when a standardized 837 claim is not used.
• Identify any returned claims from clearinghouse systems, commonly known as "front-end rejections"; when a claim is not further adjudicated by the health plans.
• Prepare and process secondary claims according to currents methods.
• Respond to internal and external requests to provide high-quality support to customers and colleagues
• Manage all billing episodes when health plan information is added, deleted, or modified.
• Ensure timely medical billing for each clinic for which they are responsible.
• Keep lines of communication open with the Clinic Operation Team to ensure individualized goals are met.
• Adheres to the service policy and principle of CMG/New Seasons.
• Other duties as assigned

Supervisory Responsibilities:

(This position will supervise non-exempt staff in support roles performing duties described in "Essential Functions".)

None

(To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the competencies (minimum knowledge, skill, and ability) required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions).

Education/Licensure/Certification:

This position requires a High School Diploma or GED.

Required Knowledge:

The ideal candidate will have a familiarity with healthcare claims data and the Revenue Cycle components necessary to generate claims. The ideal candidate will also be familiar with 837 claim form formats (1500 and UB).

Experience Required:

The preferred candidate will have 1 year of recent experience in healthcare roles where they have been associated with claim data and claim production.

Skill and Ability:

The ideal candidate will be familiar with the healthcare environment and the Revenue Cycle components that lead to claim generation and payment.

Physical Demands/Work Environment:

(The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.)

Finger Dexterity:

Use primarily for writing, operating calculator, telephone, keyboard, and other office equipment.

Talking:

To convey detailed or important instructions to employees, patients, and applicants.

Hearing:

Ability to hear normal conversations and receive ordinary information.

Vision:

Average, ordinary, visual acuity necessary to observe patients and work on computers. Clear vision at 20 inches or less and distant vision at 20 feet or more.

Physical Strength:

Sedentary work; sitting most of the time. Exerts up to 10 pounds of force occasionally.

Working Conditions:

(The working conditions described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.)

• Ability to operate in an open work area with moderate everyday noise.
• Ability to travel occasionally for educational and workshop opportunities.

Core Competencies:

• Analytical skills
• Business acumen/understanding the organization
• Communication
• Attention to detail
• Ethics/values/integrity
• Information gathering
• Problem-solving
• Time management

Mental Activities:

(The mental activities described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.)

Reasoning Ability:

Ability to resolve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Ability to maintain patient and treatment confidentiality.

Mathematics Ability:

Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, and circumferences and volume.

Language Ability:

Ability to read, analyze, and interpret general periodicals, professional journals, technical

procedures, and governmental regulations. Ability to write reports and business correspondence.

Ability to effectively present information and responds to questions from groups of managers,

employees, patients, and the general public.

40 hoursCMG Corporate

This job has expired.