Job Description

Job Description

UP Health System - Marquette

Performs billing and revenue cycle functions in the clinic or billing office, including coding, billing, payment processing, adjustments, collections and timely resolution of claims.

1. Maintains established hospital and departmental policies and procedures, objectives, performance improvement program, safety, environment of care, management of information, and infection control standards.

2. Utilizes excellent customer service skills at all times.

3. Complies with federal and state law and accrediting and licensing agencies at all times, to include but not limited to, JCAHO and federal compliance regulations.

4. Utilizes appropriate telephone skills.

5. Maintains a working knowledge of the practice management computer system, including proper data entry for demographics, charges, payments and coding. Demonstrates a working knowledge of posting fields. Collects accurate patient pay balances.

6. Demonstrates knowledge of departmental procedures, insurance billing, Common Procedural Terminology (CPT) and International Classification of Diseases (ICD9), Healthcare Common Procedure Coding (HCPCS) coding.

7. Demonstrates knowledge of Clinic Collection procedures for past due amounts, including requesting payment for balances due while the patient/guarantor is in the office and facilitating appropriate payment plans if warranted.

8. Codes hospital services for billing into the computer system, identifying correct patient, guarantor, third party payer, date and place of service, etc.

9. Researches rejections from insurances based upon medical necessity and reviews said rejections with the provider if warranted to obtain accurate diagnosis or coding that may result in payment of the claim.

10. Performs appointment scheduling, obtains prior authorizations and schedules hospital procedures/tests.

11. Enhances professional growth and development through participation in educational programs, current literature, inservice meetings, and professional conferences.

12. Participates and attends meetings and inservices as required and/or assigned.

13. Performs other related duties as assigned or requested.

Job Requirements

Minimum Education/Experience: High school graduate and one year clerical experience OR- one year business/specialized training

Preferred Education/Experience: Knowledge of ICD-9 coding, knowledge of CPT/HCPCS coding, experience with current practice management software, basic math skill, proficiency with adding machines, medical terminology, ability to work as part of a team

Required Testing: Wonderlic Review of score only

LifePoint Health is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans status or any other basis protected by applicable federal, state or local law.