Billing Specialist Ii

SUMMARY

Reporting directly to the Sr. Manager of Patient Financial Services and under the general direction of the Chief Financial Officer, the Billing Specialist performs in a multifaceted role to minimize outstanding receivables and optimize collection performance. This position will include coding, claim submissions, posting/reconciliation, claims follow-up and self-pay accounts. A remote position will be considered for applicants living outside of the Copper River area, providing they can show previous successful remote employment or references that validate a strong unsupervised work ethic. A HIPAA compliant home office is required for remote workers.

DUTIES AND RESPONSIBILITES

• Support and demonstrate the values of Copper River Native Association with an understanding and sensitivity to Alaska Native culture and lifestyle.
• Conduct activities in an ethical manner, with integrity, honesty and confidentiality.
• Maintain professional conduct in all interactions with staff and clients.
• Work collaboratively with a team perspective to meet common goals.
• Positive attitude and flexibility while dealing with a complex, multipayor system and multiple EHRs.
• Participate in quality improvement efforts on an ongoing basis; adapt positively to change.
• Effective communication, organizational, and problem-solving skills.
• Excellence in customer service skills.
• Able to work independently and meet productivity standards.
• Detail oriented.

Account Management

• Full revenue cycle activity, from accurate and complete submission of claims to final account and ultimate zero balance.
• Work with front desk staff to ensure collection of demographic and benefit information. On occasion this may require contact with patients for verification of payor.
• Monitor claim reports and contact payors to follow up on stale or denied claims. Work with PFS manager to file claim appeals.
• Ensure statements are mailed on a regular basis, may perform soft collections for patients with past due accounts.
• Work with patients to explain statements, sliding scale fees, and establish payment plans in a courteous and empathetic manner.
• Claim submission to HRSA portal for uninsured COVID vaccine and testing clients.
• Monitor claims bench in Genesis EHR for follow up and corrective action.
• Reconcile deposits with remittance advices and post or upload to third party billing software.
• Apply knowledge of standard medical billing rules and regulations to effectively determine course of action on each account and for billing of secondary payors.
• Must stay current on all CMS/commercial payer billing requirements and regulations.
• Demonstrate proficiency with a variety of automations, including but not limited to, Cerner, Genesis, AKAIMS, Dentrix, Excel, and payor websites.
• Maintain HIPAA compliance in handling patient information.
• Special projects and other duties as assigned by PFS manager or CFO.
• Leads department in projects and acts as preceptor to new department staff.
• Acts as subject matter expert in area of billing focus to internal CRNA stakeholders.

QUALIFICATIONS

• Bachelor’s Degree in Life, Social, or Health Sciences required.
• 5 years of medical billing experience required.
• Multidisciplinary practice or extensive experience in one of CRNA’s clinic disciplines required.
• 10 years of medical billing experience preferred.
• Billing Certification through AAPC or another certifying body preferred.

WORKING CONDITIONS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

The work is generally sedentary, requiring routine walking, standing, bending, and carrying of items weighing less than 25 lbs.  The majority of work is performed in an office setting with a wide variety of people with differing functions, personalities, and abilities.  CRNA is a non-smoking campus.  May require local travel between compact services of CRNA which may involve exposure to extreme weather conditions.  Works in an environment where protection of client confidentiality is essential.  Personal Protective Equipment will be provided where/when needed.

SPECIFICATIONS

Supervision Received:

Work will be monitored through meetings, reports, and regular communication with the immediate supervisor.  General guidelines for operations are based on program requirements, conditions of grant award(s), and the general policies and procedures of CRNA. 

Supervision Exercised:

Position will not provide direct supervision.

Contacts:

Contacts include and not limited to volunteers, organizational staff, clients, and outside agencies.

CONDITIONS OF HIRE

• All employment at CRNA is "at will."  This means that the employee or CRNA may terminate employment at any time and for any reason.  Unless specified in writing, no term of employment is expressed or implied for this position.
• CRNA is a no tolerance workplace.  All employees must pass an initial and random drug and alcohol screening to be eligible for and maintain employment.
• CRNA has several positions which require a criminal background check for the safety of our clients.  All employment offers in the "covered" classification are conditional until CRNA has received a Federal criminal background check verifying eligibility to work in these programs.
• First Aide/CPR certification must be obtained within 90 days of hire for required positions.
• As applicable by position and company policy, must meet standards for fitness for duty, immunizations, credentialing and privileging.