Job Information
Grene Vision Group RCM/Claims Readiness & Billing Specialist in Wichita, Kansas
This job was posted by https://www.kansasworks.com : For more information, please see: https://www.kansasworks.com/jobs/13046308
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Charge review & posting of paper fee tickets as applicable.
- Resolve claim edits daily while noting account actions for a complete audit trail of billing activity.
- Ensure all prior days edits have been accurately resolved and the claim is ready to bill.
- Submission of assigned claims to third-party payers.
- Process clearinghouse rejections daily for assigned payers.
- Maintain applicable system and website logins and review payer correspondence or bulletins for protocol or regulatory changes.
- Maintain a complete understanding of bill edit and submission protocols within required software systems.
- Identify opportunities for new claim edits and provide recommendations to management for the implementation of identified edits.
- Identify root cause issues causing claim edits and communicate these issues to RCM leadership for upstream education via an understanding of how billing edits impact overall AR.
- Adhere to ECP confidentiality policy which includes verbal, written, computer-generated, computer accessed, filmed, and recorded information related to patients, their family and visitors, staff, physicians, clients, and is responsible for the protection of the confidentiality of data at all times.
- Work safely and follow all ECP safety requirements, reporting all incidents, near misses, and adverse events.
QUALIFICATIONS
- Possess strong working knowledge of CPT coding and ICD10 coding as it relates to ophthalmology medical services.
- Understand the utilization of modifiers and other coding rules to include the AMA and other coding organizations.
- Knowledge of medical terminology and consistent application of medical documentation requirements.
- Ability to follow policies and procedures for compliance, medical billing, and coding
- Ability to type and enter data with proficiency and accuracy.
- Ability to prioritize tasks and goals while remaining detail-oriented.
- Excellent customer service skills.
- Knowledge of medical terminology, healthcare coding systems, and clinics functions.
- Experience in the use of CPT and HCPCS.
- Previous Retina coding experience.
- Experience in Optometry/Ophthalmology physician practice environment.