Payment Posting Specialist at Lags Spine and Sportcare Medical Centers Inc in Ventura, CA

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Description:

Job Description: Looking for a well-rounded Payment Posting Specialist. Ideal candidate has a minimum 2 years of experience posting payments/follow up, ICD-10, CPT, HCPCS coding systems, E&M Auditing, as well as a Medical Office Management background. Candidate must have the ability to work toward creating and maintaining good relationships with physicians, supervisors, co-workers, insurance carriers and patients. Additionally, ideal candidate will foster working as a team; dealing with and resolving conflict in a timely, efficient and positive manner and is willing to mentor and train non-billing staff about insurance and billing workflows pertinent to their particular job functions (i.e. front office, collections, eligibility, benefits and authorizations teams, etc).

Knowledge, Skills and Abilities:

1) Knowledge of payment posting processes

2) Knowledge of adjustment codes and denial reasons

3) Knowledge of health insurance programs, coverage offered and third-party reimbursement mechanisms, including Medicare, Medi-Cal, PPO, HMO, IPA, PMG, Military and Veteran, Workers Compensation and their billing guidelines and processes

4) Knowledge of eligibility, benefits and authorizations processes

5) Knowledge of electronic medical record systems

6) Knowledge of ICD-10, CPT and HCPCS coding systems

7) Knowledge of chart review and documentation auditing

8) Knowledge of manual and electronic billing systems and procedures

9) Knowledge of appeals and appeals process for different payers

10) Knowledge of general office procedures to create efficient and positive work environment

11) Skill in communicating effectively to peers, supervisors and patients and to handle stressful situations appropriately

12) Audits insurance information for appropriateness in current billing system and is able to quickly identify underpayments or other trends that may negatively affect cash flows

13) Ability to read and interpret explanation of payment from different payers

14) Ability to prioritize work and able to work with little or no supervision

15) Ability to follow up with payers on denials and under payments

Productivity:

1) Ensures posting of payments meet standards set by medical corporation

2) Uses good judgment when auditing, preparing and billing charges to other entities for payment

3) Completion of daily, weekly and added special projects

Quality Management:

1) Constantly alert for ways to improve customer service, improve patient flow, increase productivity, and improve utilization of resources communicating ideas to supervisor

2) Maintains infrequency of denials in the billing process

3) Ensures that electronic and paper payments are accurate and completed in a timely manner

4) Verifies and ensures competency when utilizing EMR and Billing systems

5) Uses mathematical accuracy and attention to detail

6) Ensures provider correction requests are responded back to billing in timely manner

7) Notifies supervisor of unusual occurrences and adheres to policy regarding incident forms and/or patient complaints

8) Attends and actively participates in staff meetings as requested

9) Attends and actively participates in staff trainings, webinars and seminars as requested

Reliability:

1) Positively supports requests from administrative office and supervisor in implementing policy and new programs

2) Dependable and punctual

Customer Service:

1) Sets the example of exemplary patient and insurance customer service

2) Responds to patient or insurance representative calls in a professional manner

3) Reviews the terms of service performed, sliding fees, third party payments and payment collection with patient via telephone

4) Ensures cleanliness of work environment during operational hours and is always prepared to provide friendly assistance to patients, insurance and staff members

.Requirements:


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