Billing Responsibilities: Under the supervision of HealthRIGHT360’s Revenue Cycle Manager Manager, the billing specialist is responsible for accurate and timely scanning of EFT’s, checks, EOB’s, claim Inquiries, denials, RTD’s and correspondence to PMG or other entities. The position is responsible by obtaining any additional information that may be needed to complete claims (Dx codes, CPT codes, note signatures, etc). Maintain and ensure proper coding for encounters including updates of ICD-10 and CPT codes.
Bank Statement Reconciliations. Weekly Reconciliation the front desk cash logs, co-payments, and deposits to EMR and turn into fiscal. Along with the Revenue Cycle Manager and Directors of Operations investigate, post, and manage EMR payments and deposit into bank.
Under the direction of the Revenue Cycle Manager develop and manage electronic billing system by inactivating and adding new/discontinued CPT and ICD10 codes, updating the Federal Poverty Level, Sliding Scale Fees and Charges on an annual basis.
Regular management of HealthRIGHT 360’s Medical Program’s funding sources, including Medi-Cal, Medicare, Family PACT, Managed Care and Commercial Insurances.
Daily management of Return to Clinic (RTC) errors.
Daily processing of clinic/billing mail and work with PMG and Internal billing department to process ACH, remits, etc. and scan/upload to appropriate folders for processing.
Under supervision of the Revenue Cycle Manager process patient refunds as necessary.
Notify PMG of all termed/hired employees. Obtain all provider materials needed for credentialing providers with all payer sources. Work with PMG on outstanding AR.
Compliance Responsibilities: Ensure clinic stays in compliance with billing requirements (i.e. Medi-Cal/Medicare/HRSA compliance).
Assist Medical Records department in providing billing records for patients upon request.
Customer Service: Work directly with patients and Revenue Cycle Manager to address patients concerns or billing or statement concerns. As requested work with patients to explain the breakdown of fees and collect payment.
And, other duties as assigned.