Duties and Responsibilities:
  1. File all charge, payment and adjustment batches in the appropriate format by batch date for quick reference.
  2. Provide customer service both on the telephone and in the office for patients and authorized representatives regarding patient accounts.  Patient calls regarding accounts receivable should be returned within 2 business days to ensure maximum patient satisfaction.
  3. Verify demographic and insurance information as needed to insure accuracy. Update the practice management system as required.
  4. Follow-up on outstanding insurance claims at 31-days from the date of submission.
  5. Follow-up on all returned claims, correspondence, denials, account reconciliations and rebills within five working days of receipt to achieve maximum reimbursement in a timely manner with an emphasis on patient satisfaction.
  6. Provide information pertaining to billing, coding, managed care networks, insurance carriers and reimbursement to physicians, managers and coworkers.
  7. Submit primary and secondary insurance claims electronically and on HCFA forms on a regular basis to ensure timely reimbursement. 
  8. Monitor reimbursement from managed care networks and insurance carriers to ensure reimbursement is consistent with current contracted rates.
  9. Utilize and become proficient using provider portals for eligibility verification and claim status and to efficiently conduct accounts receivable follow-up.
  10.  Maintain information regarding coding, insurance carriers, managed care networks in an organized easy to reference format. 
  11. Adhere to write-off policies, refund policies and other accounts receivable policies as outlined in the Procedure Manual.
  12. Other duties as assigned.
Organizational Duties and Responsibilities:
  1. Become proficient with the clinic’s electronic medical records system
  2. Maintain compliance with federal and state regulations such as HIPAA, Privacy & Security, and Infection Control)
  3. Follows all GPWHC Employee Handbook and policies and procedures
  4. Respect and promote patient rights
  5. Demonstrate a cooperative work attitude and show respect toward physicians, coworkers, management, patients, visitors and sales representatives.
  6. Identify ways to improve practice operations.
Working Conditions:
  1. Combination of sitting, standing, bending, light lifting and walking.
  2. Requires a full range of body motion including manual and finger dexterity and hand-eye coordination.
  3. Requires corrected vision and hearing to a normal range.
  4. Requires the ability to manage stressful situations.
  5. Occasional stress from varying demands.
  6. Is susceptible to communicable disease transmitted by patients and co-workers
Knowledge and Skills:
  1. Requires a comprehensive understanding of accounts receivable management in a healthcare setting.
  2. Working knowledge of managed care plans, insurance carriers, referrals and pre-certification procedures.
  3. A strong working knowledge of CPT, ICD-10, HCPCS, modifiers, coding and documentation guidelines is encouraged. 
  4. Strong customer service, organizational and communication skills are essential.
  5. Ability to prioritize multiple tasks simultaneously in an occasionally stressful   environment.
  6. Strong computer and typing skills and a working knowledge of Medicare Compliance
  7. Accurate and precise attention to detail
Qualifications:
  1. High School Diploma or GED certificate is required; Bachelors’ degree in related field preferred
  2. Two years of accounts receivable experience in an obstetrics and/or gynecology setting is preferred.
  3. CPC Certification or Equivalent is preferred
  4. Understanding of medical terminology, anatomy and physiology

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