Company :
Allegheny Health NetworkJob Description :
GENERAL OVERVIEW:
Oversees the pro-fee billing activities for the practice(s).
ESSENTIAL RESPONSIBILITIES:
- Ensures patient co-payments and deductibles are posted and compliance with system cash policies. Coordinates day to day billing work flow.
- Assists customers with patient billing inquiries and troubleshoots problems and/or issues. Identifies unpaid balances (insurance and patient) through A/R reports and takes appropriate actions.
- Performs the functions of a billing associate. Obtains and enters patient demographic, insurance, and referral/precertification information in the billing system.
- Serves as the billing expert and provides billing related support. Educates staff and physicians regarding issues.
- Maintains current knowledge of federal and state reimbursement policies/regulations and system policies pertaining to physician practice billing. Ensures compliance with regulatory requirements.
- Performs other duties as assigned or required, including but not limited to reviewing and verifying billing reports, registration, and chart audits.
QUALIFICATIONS:
Minimum
- High school diploma or GED.
- Graduate of a medical billing program or equivalent experience.
- 3-5 years’ experience in healthcare billing role.
Preferred
- Associate’s Degree.
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
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