Responsible for posting, coding, and collection of receivables.
- Receives and organizes hospital census, charge sheets and other billing data to be coded and entered into the proper spreadsheet or EPM.
- Contacts various parties to request and/or obtain missing documentation and appropriate coding.
- Reviews and ensures that correct information/ documentation has been entered into the EPM, EMR and hospital, to be able to code the charges correctly before they are billed.
- Organizes, compiles and enters all assigned charges and/or payments, balances to the system, maintains spreadsheets and logs as applicable.
- Reviews all daily charges from the “interface” and corrects errors to ensure proper billing.
- Enters patient demographic information and charges into EPM. Files hard copy based on visit and information entered.
- Provides coding feedback to the medical providers regarding billing problems via e-mail.
- Attains proper documentation from the patient’s medical record and assures that all new or denied claims are corrected utilizing CPT-4 and ICD-9 codes to insure proper reimbursement.
- Reviews, copies and appeals denials as outlined in the Explanation of Benefits.
- Audits patient accounts and generates claims for billing secondary claims.
- Audits patient accounts to ensure that refunds and adjustments are properly done.
- Handles the “CBO front desk” collections and patients with billing enquiries.
- Research and contact various parties to obtain information to submit corrected data for re-billing. Such as researching addresses from returned mail, contacting the patient for correct billing information, calling hospitals and other agencies for proper documentation, etc.
- Timely communicates, verbal or written, with payers to expedite collections.
- Handles “Billing Phone” for all patient billing questions in a timely manner.
- Contacts patient to inform them of coverage of services and their responsibility prior to appointment date. (diabetes management, etc)
- Call insurance companies to verify insurance eligibility and coverage. Requests appropriate referrals when required by the insurance companies.
- Follows Universal Precaution Procedures while performing applicable duties.
- Complies with the facility privacy policies and procedures for the management of protected health information (PHI)
- Utilizes appropriate Personal Protective Equipment in the performance of duties.
- Adheres to infection control and safety policies, including education, reporting and practice implementation specific to job position.
- Performs other duties as assigned by supervisor.
Education and/or Experience:
- Must have a high school diploma or the equivalent and may have two years of medical office experience.
- Must have at least one year of data entry experience and able to accurately and efficiently type 35 words per minute utilizing a Windows based computer software.
- Must be able to use a ten-key by touch.
- Must demonstrate appropriate verbal and written skills and ability to communicate with all ages in a professional manner.
- Must have working knowledge of CPT-4 and ICD-9 codes
We have many plans with various deductibles, which can cover individuals or families so you can customize a plan that will work for you! Steward Health Care works with Blue Cross Blue Shield of Massachusetts to provide affordable health insurance for our employees. Our Health Plans Highlights are:
- Deductibles will not apply to services provided by a Steward provider (Tier 1).
- Office visits copays will be $0 when a member uses a Steward Provider (Tier 1).
- Mental Health and Substance Abuse office visits will be $0 for all In-Network providers (Tier1, Tier 2, and Tier 3).
Steward Health Care is the largest private, for-profit health care network in the United States. The company is owned and led by a management team of Steward physicians. Headquartered in Dallas, Texas, Steward employs more than 40,000 health care professionals and operates 35 hospitals across the United States and in the countries of Malta and Colombia which regularly receive top awards for quality and safety. The Steward network includes multiple urgent care centers and skilled nursing facilities, substantial behavioral health services, more than 7,000 beds under management, and approximately 2.2 million full risk covered lives through the company's managed care and health insurance services.
The Steward Health Care Network includes more than 5,000 physicians across 800 communities who help to provide more than 12 million patient encounters annually. Steward Medical Group, the company's employed physician group, provides more than six million patient encounters per year. The Steward Hospital Group operates hospitals in Malta, Colombia and nine states across the U.S., including Arizona, Arkansas, Florida, Louisiana, Massachusetts, Ohio, Pennsylvania, Texas, and Utah. For more information, visit www.steward.org.
Steward Medical Group is taking additional necessary preparations to ensure patients can receive compassionate care in safe, carefully managed environment – with confidence and without fear.
Our Safe and Ready program consists of a rigorous [three-point] standard ensuring patient safety, confidence and convenience.
- Any COVID-19 related care takes place in designated areas away from other patients and their families.
- A stringent cleaning policy has been implemented throughout our facilities.
- A strictly controlled visitor and mask policy is required for patient and colleague safety.