Billing Functions

·                     Ability to process new and re-done financial documents; knowledge of payer requirements to 1) qualify for financial assistance, 2) report and/or invoice services; knowledge of various insurance company requirements to invoice claims for third party payment 

·                     Performs various functions for specific consumer accounts in the areas of general account maintenance, invoicing, posting, reconciling and third-party follow-ups 

·                     Works with consumer for best option of payment, timeframes, and set up payment plan when necessary and handles of inquiries from consumers, clinical staff, and third-party carriers regarding specific consumer accounts and associated transactions 

·                     Maintains documentation in compliance with organizational standards, Mental Health Codes, and licensure requirements that is complete, accurate, and timely 

·                     Assists external auditors in various phases of specific audit processes 

90%

Basic UPH Performance Criteria

·         Demonstrates the UnityPoint Health Values and Standards of Behaviors as well as adheres to policies and procedures and safety guidelines.

·         Demonstrates ability to meet business needs of department with regular, reliable attendance.

·         Employee maintains current licenses and/or certifications required for the position.

·         Practices and reflects knowledge of HIPAA, TJC, DNV, OSHA and other federal/state regulatory agencies guiding healthcare.

·         Completes all annual education and competency requirements within the calendar year.

·         Is knowledgeable of hospital and department compliance requirements for federally funded healthcare programs (e.g. Medicare and Medicaid) regarding fraud, waste and abuse.  Brings any questions or concerns regarding compliance to the immediate attention of hospital administrative staff.  Takes appropriate action on concerns reported by department staff related to compliance.

10%

Minimum Requirements

Identify items that are minimally required to perform the essential functions of this position.

Preferred or Specialized

Not required to perform the essential functions of the position.

Education:

Requires high school diploma or GED plus one semester of “Principles of Accounting” 

An Associate’s Degree in accounting is preferred 

Experience:

Requires minimum of two years’ experience in billing and cash collections within a computerized system Previous experience coding diagnoses and procedures with ICD-9-CM and CPT Previous experience with filing of medical insurance claims 

Previous experience with electronic billing preferred 

License(s)/Certification(s):

Knowledge/Skills/Abilities:

·         Knowledge of medical terminology, anatomy and physiology

·         Knowledge of medical billing and collection practices

·         Knowledge of governmental legal and regulatory provisions related to collection activities

·         Writes, reads, comprehends, and speaks fluent English

·         Multicultural sensitivity

·         Strong verbal and written communication

·         Strong interpersonal skills

·         Strong computer skills

·         Ability to understand and apply guidelines, policies, and procedures

·         Ability to work as a team member

·         Ability to read/comprehend/analyze/interpret bills, payments and related communication and insurance policy language. 

·         Ability to write consumer correspondence. 

·         Ability to present/respond one-on-one with internal and external customers. 

·         Requires good phone skills 

Other:

Use of usual and customary equipment used to perform essential functions of the position.