Third Party Billing Liaison

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Description

The primary function of this position verifies and documents third party coverage Third Party Billing Companies and the Yerington Paiute Tribal Health Clinic.

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Type

Full-Time

Department

Health Clinic

Supervisor

Business Office Supervisor

Salary

Level 11-0 $13.27, Level 12-0 $13.94, Level 13-0 $14.63 F/T 40 HR/WK

Duties

  • Directs and administers the mature 638 Combined Health Services Compact.
  • Receive receipt and reconcile all payments with Finance Office Daily
  • Track patient payments made through Medical Records to be included on Daily Collections Report and submitted monthly.
  • Track Patient Payment Agreements; assist in clearing up old account balances.
  • Collect Estimate of Benefits (EOB’s) or Remittance Advice (RA’s) from mail, on-line services and Clearing House; Match EOB’s or RA’s with payments received by Finance.
  • Work closely with Tribe’s billing Contractor to collect and review data for returned or denied claims.
  • Scan and upload all EOBs or Ras to Billing Contractor; maintain documents in organized files.
  • Assure Medical Records is processing all virtual credit card (insurance) payments timely.
  • Research and process patient and/or insurance refunds.
  • Verify insurance information as needed.
  • Integrate new providers with our group; update provider/group information with Medicare and Medicaid.
  • Produce reports for the annual audits regarding accounts receivables.
  • Post explanation of benefits in an organized manner.
  • Report all daily collections on the “Daily Practice Collection Summary” and reconcile with finance office daily (collections include cash, check or credit card payments by patient for co-pay, self-pay, paying on account balance, payroll deductions or paying for services or products).
  • Report all daily collections to Health Director, Fiscal Officer and finance office.
  • Work closely with the Tribes finance office to account for and post insurance payments.
  • Track all patient payment agreements and assist in clearing up old account balances.
  • Maintain Accounts Receivable balances and reconcile monthly with Tribal General Ledger and Third-Party Billing Company.
  • Act as resource for all departments related to billing, pricing, coding, documentation and notifications from Billing Contractor.
  • Complete insurance provider enrollment application packets for the Clinic.
  • Abide by the Tribe’s Clinic Fiscal Policy and Collection Policy.
  • Understand and comply with HIPAA rules and regulations and other privacy laws.
  • Performs other duties as assigned.

Qualifications

  • High School Diploma or Equivalent.
  • Two years Medical Billing experience or Certified Medical Biller preferred.
  • Experience working with computers and Microsoft Office Software.
  • Background in Health Information Systems preferred, IHS.RPMS experience preferred.
  • Be able to work independently with minimal supervision.
  • Excellent customer service skills and high regard for confidentiality.
  • Must have good time management skills and be able to complete tasks assigned in a timely manner.
  • Excellent written and oral communication skills.
  • Have a CPR Certificate
  • Pass pre-employment drug screen and complete background investigation.
  • Possess a valid Nevada driver’s license.
    Able to lift 40lbs or more.

Application Deadline