Adhere to all Anderson Hills Pediatrics' Policies and Procedures
Conduct self in a manner that represents Anderson Hills Pediatrics' core values at all times
Maintain a positive and respectful attitude with all work-related contacts
Consistently reports to work prepared to perform the duties of the position
Meets productivity standards and performs duties as workload necessitates
Assists the Billing Manager with the claims submission and revenue cycle of the practice.
Adherence to current HIPAA regulations and federal/state laws for patient protected health information (PHI) and/or medical records; adherence to all AHP policies/procedures as they pertain to patient PHI and the medical record; maintain strict confidentiality of all patient information
Update patient demographic information including insurance coverage; make changes/corrections as needed; verify patient insurance benefits when applicable
Process required referrals to specialists and/or facilities
Audit charges from EMR for accuracy in CPT /ICD-10 / HCPCS coding
Pursue any outstanding claims and/or appeal any denied or underpaid claims
Respond to requests for medical records from insurance companies
Post patient and/or insurance remittances
File insurance claims daily
Perform daily close of the day
Investigate, analyze, and follow up for collection of overdue accounts
Initiate and respond to telephone inquiries from patients, insurance companies, others
Process BCMH applications as needed
Participate in quality improvement initiatives as needed
Complete necessary training on topics including, but not limited to, care coordination, patient self-management, population management, and health literacy
Attend monthly staff meetings and scheduled department meetings
Other miscellaneous duties as assigned by the Billing Manager
Works with patients/families, insurance companies and Finance Manager
Works with physicians, other managers, and staff as needed
Education: High school diploma
1-3 years of medical billing office experience preferred
Coding certification required
Experience in pediatrics preferred
Demonstrate excellent listening skills and problem-solving skills
Ability to interpret, adapt and apply guidelines and protocols
Ability to willingly invest in change processes to improve efficiencies, compliance, and overall AHP performance
Exceptional interpersonal skills, including the ability to establish and maintain effective relationships with physicians, other employees, and patients
Excellent critical thinking skills; exhibit sound judgment in decision making
Excellent communication (both oral and written)
Demonstrate strong customer service skills, including the ability to use appropriate judgment, independent thinking, and creativity when resolving customer issues
Initiative and ability to work independently, lead/work in teams, and deal persuasively and effectively with all levels throughout the organization.
Ability to manage multiple projects in varying stages of development; excellent problem-solving skills and attention to detail.
Must be able to receive constructive criticism and react quickly to change.
Ability to balance and shift multiple priorities.
Works in clinical areas as well as throughout the facility
Sits, stands, bends, lifts and moves intermittently during work hours
Relocation not available