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Medical Biller
Empresa:

Mednax


Lugar:

Guaynabo

Detalles de la oferta

Overview MEDNAX has grown from a single medical practice to a trusted health solutions partner with more than 10,000 employees and a presence in 50 states. Through our family of companies, we provide: physician services spanning the continuum of patient care revenue cycle management solutions performance improvement consulting We invite you to grow with us and help shape the future of health care. JOB SUMMARY: The PR Biller is responsible to analyze, monitor and control the billing process through the key indicators and data controls, in order to ensure the integrity of billing data. Is responsible to perform complex updates to the billing systems, including evaluating and correcting error conditions. Applications utilized are: MS Word, Excel, OBR, GPMS, RDS, Baby Steps, Onbase, E-Mail, Internet, Master Database, and Imaging. Responsibilities Complete daily process as established. Print GPMS Electronic Claims Register (E28 & E26) and Inmediata Reports (acknowledge of receipts, submitted files, 277U, electronic rejections) and the Triple S and Triple S Mi Salud Rejections Reports. Identify the claims rejected and accepted. Work with rejected accounts to resolve the issues identified and document accounts in GPMS per format established until resolution. Print Paper Claims Run from E2 and file the claims by payers. Work with the payers' rejections received by mail. Work with the Rejections Tracker Log to ensure rejections are solved within the established timeframe. Work the OBR Updates Icon to update accounts in GPMS. Monitor & Analyze all registrations and charges following the established procedures: Document accepted electronic and paper claims in GPMS accounts by using the format established. Work with Paper Claims Billing and submit to payers within the established timeframe. Identify accounts that need to be updated with Claim Group X until resolution. Continuously monitor and audit the billing process and operations and forward findings to associates and Billing Supervisor. Review errors with associates and monitor errors until resolved. Work closely with associates to assist in resolving registration and charge issues. If necessary, request medical records or other documents required for billing as the established process. Forward medical documentation to the Coding Department if necessary, in order to resolve questions on the charges. Identify opportunity for new claims manager edits based on billing analysis of rejections trends. Forward to BACP the edit error corrections (EEC's) via e-mail every Friday, using the established spreadsheet and give the proper follow up until resolution. Work closely with Billing Supervisor on past filing limits denials. Elevate and identify trends to Billing Supervisor. Update each account in OBR with requested changes as required. Participate in Regional Meetings, as required. Work special projects at the Billing Supervisor's direction. Responsible for claim formats and test suites. Validate the tests in production once implemented. Act as a liaison to the Corporate office for testing or changes. Meet or exceed required departmental productivity standards on a consistent basis. Meet quality and quantity productivity standards. Also, PR Biller will act as backup of the Regional Hospital Associate (RHA) and may perform other duties as assigned below: Work on a daily basis certain eligibility reports produced through the auto eligibility software. Print, review and work OBR reports & resolve Hold• Codes. Responsible to work specific hold codes of those payers set up for the automated eligibility searches. Run Hold Codes for OBR Registration, as scheduled.Take action according to Action Code Follow up requirements and document each account worked with appropriate Action Code. Run CPT by FAC/DOS Summary, as scheduled to check the accounts with missing charges and refer the accounts to the Hospital Associates via email. Run Registration Edit Report, as scheduled, and refer to the Hospital Associates via email the accounts with XXX in Physician, Referring Physician and/or Payer Code fields. Run Timely Filling Report, as scheduled and refer to the Hospital Associates the accounts via email. Run Unbilled Registration Report, as scheduled, to check for registrations created that have no billing attached and refer to the Hospital Associates. Work closely with local Hospital Associates to assist in resolving registration error issues preventing the account from qualifying for auto eligibility process. Elevate any identified trends to Hospital Associate Supervisor. Validate active insurance coverage for all patients within the region by contacting insurance companies and/or parents to verify valid eligibility or errors that can not process the accounts. Prepare and submit daily and monthly statistics to Supervisor as requested. Work the OBR Updates Icon to update accounts in GPMS. Make necessary telephone, electronic or written contact. Contact parents to obtain accurate insurance information. Send appropriate letters to parents. Provide support service to other departments. Provide support services to the Corporate Office by providing additional information needed on accounts, i.e. billing disputes, billing dept, coding dept, etc. Provide support to the Patient Accounts Department.• Update insurance or demographic information on accounts.• Contact with collectors on account issues such as account histories.• Review and reply to corporate e-mails in a timely manner. Meet or exceed required departmental productivityand quality standards on a consistent basis. Perform a variety of other duties. Work CP Start & Accounts >$5K & $50K 60 days Reports on a weekly basis and update accounts for resolution. Work the Undelivered Address Listing E-mails received from Corporate. Assist on various special projects as determined by the Supervisor/Manager. Attend scheduled monthly meetings -via telephone and/or web access. Maintain strict confidentiality in accordance with HIPAA regulations and Company policy. Any patient private health information (PHI) must not be divulged on any account except to payers that need the information in order to process the claim for payment. Presents a positive, professional appearance and conveys a professional demeanor in the performance of assigned duties. Performs other job-related duties within the job scope as requested by management. Embodies the principles of the corporate Mission Statement and Philosophy at all times. • Conducts all business in a professional manner -maintaining respect for individuals at all times - and represents the corporation in a positive fashion and makes all individuals feel as comfortable possible. Complies with departmental and company wide policies and procedures. Maintains constant awareness of potential safety hazards insuring necessary safety precautions. Qualifications One year certificate from college or technical school; or one to two years related experience and/or training; or equivalent combination of education and experience. Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to add and subtract two digit numbers and to multiply and divide with 10's and 100's. Ability to perform these operations using units of American money and weight measurement, volume and distance. Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. MEDNAX IS AN Equal Opportunity EmployerAll qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status SDL2017


Fuente: Adzuna_Ppc

Requisitos

Medical Biller
Empresa:

Mednax


Lugar:

Guaynabo

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