Job Description

General Summary

Under general supervision, prepare hospital patient bill, post and enter billing information, prepare reports, and track patient accounts related to billing issues. Set-up and maintain comprehensive records and files. Research and reconcile billing problems according to procedures.

Principal Responsibilities and Tasks

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. These are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

1. Prepares hospital patient bill by reviewing and verifying patient charges, coordinating benefit level, type of coverage, and/or approval for coverage; reviews hospital charges for accuracy, makes adjustments for duplicated or incorrect billing, as appropriate; calculates and determines level of patient benefit and enters appropriate proration into PMAS; forwards bill to third party payers.
2. Posts and/or enters updated billing information into the computerized billing system, PMAS, via computer; transfers routine data from one patient record to another record to ensure accurate coverage coding. May assign codes to Blue Cross bills as needed.
3. Updates and/or maintains patient account tracking system using computer station; evaluates patient file to ensure that all data is available prior to releasing patient account information for billing.
4. Prepares regular and/or specialized reports which involve gathering specific information, compiling and summarizing data to provide interpretation of results, and preparing tables and/or graphs of pertinent data.
5. Interacts, as needed, with other UMMS departments such as, Medical Records, and Utilization Review to obtain information to meet requirements for third party billing.
6. Reviews various documents from various UMMS departments and/or third payers that are required for billing; reviews documents for accuracy of patient data and billing information, as needed.
7. Retrieves hospital account records for purposes of rebilling; updates and/or corrects documents with additional patient account information, codes, and indices; replaces updated information into the appropriate patient account folder.
8. Makes and receives telephone calls to and from patients, insurance companies and other third party payers to ensure accurate and complete information is available. Verifies billing requiring pre-certification as necessary.
9. Responds to patient, lawyer, auditor, and collection agent requests for information and/or replicated documents; ensures patient confidentiality is maintained at all time, in accordance with hospital policy and procedure.

Qualifications

Education and Experience

1. High School Diploma or equivalent (GED) is required.
2. Two years of work experience in third party billing obtained in a hea1thcare related work environment is required.

Knowledge, Skills and Abilities

1. Demonstrated knowledge of third party billing, ICD9-CM and revenue coding, Medicare Assistance and Medicare systems, and related forms is required.
2. Demonstrated ability to perform basic mathematical calculations including percentage, addition, subtraction, and multiplication using a calculator, or related equipment
3. Ability to operate a computer, typewriter, and personal computer with working knowledge of the keyboard configuration. Ability to utilize Microsoft Office software, and/or related software. Capable of operating related standard business machines such as microfilm and photocopier.
4. Highly effective verbal and written communication and listening skills are required to interact with various individuals information and/or resolution of patient accounts

Patient Safety

Ensures patient safety in the performance of job functions and through participation in hospital, department or unit patient safety initiatives.

1. Takes action to correct observed risks to patient safety.
2. Reports adverse events and near misses to appropriate management authority.
3. Identifies possible risks in processes, procedures, devices and communicates the same to those in charge.

Additional Information

All your information will be kept confidential according to EEO guidelines.