Qa specialist serp_jobs.h1.location_city

Job Posting

Level : Experienced

Job Location : Bellmead, TX

Position Type : Full Time

Education Level : High School

Travel Percentage : None

Job Shift : Day

Job Category : Health Care

Description

Primary Duties :

• Maintain a current knowledge of insurance carrier and / or state program claims filing policies and procedures
• Verify patient demographics and financial coverage; update as needed
• Research and verify patient and / or insurance company and / or state program refunds / recoupments
• Adjust patients accounts to reflect changes in payment responsibility
• Verify accuracy of information on paper medical claim forms and mail to selected insurance carriers and / or state programs
• Research patient charges not automatically assigned to selected insurance carriers and / or state programs, make corrections and assign manually
• Maintain patient accounts; give GHC program discounts and / or other adjustments as needed
• Appeal service charges rejected by selected insurance carriers and / or state programs and resubmit amended claim forms
• Process claims / vouchers as needed for insurance plans and / or state programs
• Obtain pre-certifications, prior-authorizations, or referrals for special provider services as needed
• Verify motor vehicle or accident information with patient's insurance carrier
• Maintain work ques with claim errors
• Assist insurance carriers and / or state programs to acquire supplemental patient information needed to process claims
• Assist patients to understand fees for services and billing processes
• Assist patients to make payment arrangements and find financial assistance
• Assist outside providers and vendors to obtain physician billing information
• Assist employees to understand policies and procedures related to billing matters
• Communicate and support training issues with billing staff
• Comply with all regulations related to confidentiality of patient information
• Maintain and / or create new payor and plans as needed
• Able to manage multiple priorities and manage stress appropriately
• Communicates appropriately and clearly with a pleasant and professional manner to all
• Demonstrates excellent judgment in handling situations not covered by written or verbal instructions
• Demonstrates a commitment to the mission, core values, and goals of Waco Family Medicine and its healthcare delivery including the ability to deliver exceptional patient focus with quality, compassion, and respect
• Maintain certifications and website passwords as applicable

Other Duties :

Physical and Mental Requirements :

Qualifications

Reports To : Director of Billing Services

Education : High School Diploma or Equivalent required, College Hours preferred

Skills : Computer literacy, knowledge of ICD-10 CM / CPT coding, medical office billing and collection practices, federal / state / local financial assistance programs, strong interpersonal, oral, and written communication skills, excellent telephone, and customer service skills.