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Form of workThe Cook Hospital is seeking a Medical Records Secretary/LTC Biller to join our team! The position is responsible for all administrative functions related to handling, releasing, and processing of health information, credentialing, and coordination of medical record accuracy and completion. The position performs Care Center billing, reporting, tracking, and maintaining account accuracy.
Education: Some technical, junior college, or health related certification.
Experience: Two years' current experience with general business office practices within the health care industry, or education/certification in a health-related field. Knowledge base and experience working with medical terminology is highly recommended. Computer skills and working with the public required.
Essential Functions:
- Utilization of Meditech B/AR, ADM, MRM, MRI modules.
- Processing physician/practitioner credentialing.
- Completing record needs through the Incomplete Record routine in Meditech.
- Release of Information (ROI) management via ROI, ER Notes, verbal/fax requests.
- Proof of ER Notes/un-sign when needed.
- Daily scanning of physician orders, path reports, labs, hire orders, external paperwork for all service lines and forwards appliable paperwork accordingly.
- Processes Death Certificates
- HCAHPS reporting.
- Prints and scans Ambulance run reports into patient information system.
- Update patient records when deceased.
- Performs Medical Record merging in Meditech.
- Care Center thin out charts and filing orders/paperwork.
- Back-up support in covering the Front Desk/Admission duties when needed.
- Keeps track of LTC admissions, discharges, custodial/skilled status, hospital, and therapeutic LOA days.
- Reviews financial documents with new resident upon admission with family members.
- Submits Nursing Facility (NF) Communication Forms to correct PMAP provider within 48 hours of new admission. Faxes in updated forms if RUG rate changes throughout the benefit period. Sends in another form after 180 days has been met, or if resident discharged during the benefit period.
- Prepares financial folder for each new resident when they are admitted and establishes appropriate insurance contract.
- Bills the RUG plus 20% for the first 30 days from admission.
- Bills 11.5% higher private room custodial rate for those residents that meet medical necessity.
- Assists the resident's family with financial information in submission of the Medicaid application and in referring them to St. Louis County Social Services.
- Is responsible for meeting insurance payer deadlines for payment.
- Sends a statement each month to the resident or resident's financial representative for the recipient resource amount that request one, and for previous month's room and board charges when self-pay.
- Sends financial representative a case mix letter of explanation whenever the RUG rate changes within 3 business days of being notified.
- Is responsible to follow up on late payments in a timely manner for LTC residents.
- Works with the MDS Coordinator to confirm skilled dates and PDPM levels from the Meditech system, and in communicating new resident information being submitted to MA.
- Responsible for billing all ancillary and therapy Part B LTC claims.
- Research LTC accounts that have credits for initiating appropriate takebacks.
- Enters pharmacy and supply charges when residents are skilled before closing the month the supplies were incurred.
- Emails St. Louis County for any resident discharge or death.
- Keeps LTC dictionaries in Meditech up to date and creates new entries in the Matrix when applicable.
- Reports quarterly census to Leading Age when requested.
- Processes chart audits when needed.
- Other duties as assigned by the Director Revenue Cycle
- Work independently and as a team player.
- Self-motivated, organized and prioritize tasks appropriately.
- Comply with HIPAA policies.
- Demonstrate knowledge and compliance with facility-wide and departmental policies and procedures.
- Meets attendance policy requirements.
- Exhibits high moral and behavior standards consistent with personnel policies.
