Under general supervision, to perform work providing billing service to patients and providers with insurance, billing, collections and registration issues in the Physicians Group Practices. Supports facility functions, while working independently through data processing and report generation. Interacts with internal departments, businesses, insurance companies and billing services.

PRINCIPAL DUTIES AND RESPONSIBILITIES(*Essential Functions)

1. Acts as liaison between patients and billing services, physician group, billing services, patients and office claims, businesses and office claims, and providers and patients.
2. Assists in maintaining compliance with regulatory standards applicable to areas of responsibility as required by accreditation bodies.
3. Assures current ICD and CPT coding for billing purposes is accurate and correct in the billing system.
4. Enters data for all encounters performed at the patient care areas.
5. Completes patient forms, reports, precertifications, prior authorization, referrals and statistics.
6. Prepares providers schedules, sorts, distributes, and prepares mail for mailing, and for daily deposits and deliveries.

JOB SPECIFICATIONS (Minimum Requirements)

KNOWLEDGE, SKILLS, AND ABILITIES

• Knowledge of medical terminology, statistical and data collection.
• Knowledge of current ICD and CPT coding and ability to apply such coding given the service provided.
• Proficiency in applying rules and regulations with regards to Medicaid, Medicare, and insurance companies.
• Demonstrated oral and written communication skills.
• Possess good interoffice and public relations/communication skills, and analytical skills.
• Strong interpersonal and data entry skills.
• Ability to assess and interpret data about the patient's status.
• Ability to multi-task, prioritize job assignments to keep abreast of the workload, and to remain organized given high volume of workload.
• Ability to work independently and exercise good judgment, and to work in a team environment.
• Ability to defuse/handle irate customers and to be responsive to customers' requests.
• Ability to remain professional at all times and to work cooperatively with patients and staff members.

EDUCATION

• High School Diploma/GED Equivalent Required

EXPERIENCE

• 2 years Experience Healthcare Billing Office Required

LICENSE/CERTIFICATION

• Professional Coder Certification Preferred

STANDARDS OF BEHAVIOR
Meets the Standards of Behavior as outlined in Personnel Policy and Procedure #1, Employee Relations Code.

CONFIDENTIALITY/HIPAA/CORPORATE COMPLIANCE
Demonstrates knowledge of procedures for protecting and maintaining security, confidentiality and integrity of employee, patient, family, organizational and other medical information. Understands and supports the commitment of Methodist Hospitals in adhering to federal, state and local laws, rules and regulations governing ethical business practices for healthcare providers.

DISCLAIMER - The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. The statements are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required.