Summary/Objective: Responsible for maintaining good client relations. Processing Medicare, Medicare Advantage and Medicaid claims posting Medicare and Medicaid payments. Filing supplemental claims for patients with secondary insurance policies to Medicare. Refunds patients, Medicare, Medicare Advantage, Medicaid and third party claims as applicable. Primary shift is to provide weekend and holiday coverage.
- Provides courteous and thorough registration of all patients. This includes, but is not limited to; courteously greeting patients; collecting and entering essential patient information for the electronic medical record and for insurance billing purposes.
- Responsible for processing all forms and obtaining signatures as required. Answers phone in a courteous and responsive manner; takes messages, promptly returns calls, processes voice mail, disseminates information to appropriate parties in a timely, courteous and professional manner.
- Faxes confidential information while following and maintaining HIPAA compliance regulations. Must be able to process multiple faxing projects which include but aren’t limited to; patient medication refills, orders, patient referral notes, etc.
- Accurately schedules initial and follow-up patient appointments in a courteous and professional manner to comply with restrictions of department resources and the needs of the patient. Ensures that all paperwork needed for the patient’s visits are available for the nurses and providers.
- Processes schedule changes as needed and informs involved parties.
- Copies numerous forms daily as needed for patients, clinic staff and providers.
- Electronically files patient information in electronic medical record throughout the day. Examples of patient information to be electronically filed include, but are not limited to: lab results, consult, hospital, discharge, home health, progress notes, medication refills, dictations, appointments, etc.
- Creates new patients accounts and ensures all necessary documents are completed, signed and scanned into EMR.
- Reviews costs of services provided. Collects co-payments and other monies owed at the time of service. Notifies Billing Department of promises made so that they may follow up on expected payment.
- Distributes Sliding Scale Fee Paperwork & compiles necessary information for the processing of the application and turns it into manager.
- Notifies Manager of possible charity care customer, patients with delinquent balances and/or previous bad debt patients in order that 1:1 financial counseling be conducted.
- Ability to work in a faced passed environment while efficiently multi-tasking is essential.
Health Information Management
- Follows all HIPAA compliance rules and regulations regarding privacy information; educates staff on daily basis; informs patients of policies upon check-in.
- Verifies HIPAA compliant release of information, checks for correct signatures, witnesses, etc. Processes and sends, at no fee, for continuation of care information. Processes and sends with fee, in accordance with CMH policy, for lawyers, insurance companies, etc.
- Responsible for security, implementation, reproduction, correspondence, filing systems, storage, rotation, etc., of all records in clinic possession whether in hard copy or computer generated.
- Responsible for responding to incident reports generated by staff members, patients and the public.
Processes Accounts Receivable Monies
- Collects and posts patient payments into the practice management system accurately and provides patient with a receipt of payment.
- Maintains general ledger on a daily basis, balances to cash and accounts receivable reports. Processes deposit to go to bank at the end of each day.
Participates and contributes to department’s daily business operations
- Participates in monthly departmental staff meetings.
- Demonstrates safe disposal and usage of bio hazardous materials as trained.
- Does clinic errands as needed including but not limited to bank deposit, storage unit retrieval, mail and in-town supply pick up.
Other duties as assigned. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for their job. Duties, responsibilities, and activities may change at any time with or without notice.
- Completes required education/skill/competencies.
- Attends and actively participates in interdepartmental meetings/education/competencies. Actively participates by giving constructive input.
- Refers to and follows policies and procedures.
- Participates in the development and attainment of departmental goals
- Contributes to the overall functioning of CMC and the department by assisting where and when needed. Functions as a positive team player.
- Maintains a clean, safe working environment.
- Assists in QI/QA as requested including data collection.
- Effectively communicates with other team members.
- Completes required work accurately and in a timely manner.
Job Related Behaviors
- Integrity/Pride/Honor: Exhibits the highest standards of professionalism in dealings with co-workers, employers, visitors, patients and residents both inside and outside of the facility.
- Respect/Equality: Treats others as he/she would like to be treated.
- Communication: Communicates openly and honestly and in a way that is clear and understandable. Uses positive communication and communicate appropriately with all CMC departments.
- Compassion: Creates an environment of safety and trust for patients/residents/employees
- Trust: Demonstrates trust in co-workers.
- Professionalism: Demonstrates honesty and integrity. Always strive to give 100%
- Safety: Creates/Ensures that work environment is safe for patients, residents, employees and visitors.
- Fiscal Responsibility: Is a good steward of CMC resources.
- Ambassadorship: Uses good judgement in behavior, appearance, words and actions. Remembers that employees are on stage at all times.
- Quality: Is proficient, competent and efficient.
- Teamwork: Lends a hand whenever possible to ensure top-notch patient/resident care.
- Commitment: Committed to co-workers, patients, residents and providers.