Medical Biller Position Available In Oswego, New York

Medical Biller 2.9 2.9 out of 5 stars 110 West 6th Street, Oswego, NY 13126 BROAD

FUNCTION

The primary function of this position is to manage the daily operational billing processes for all of the hospital system service lines including but not limited to: Timely electronic and paper claims billing transmissions; Management and resolution of the returned or claims held for missing or invalid billing data; Compliance with all billing and reimbursement rules and regulations for both governmental and nongovernmental payers; and Achievement of established functional work stream Key Performance Indicator of a clean first submission claims rate of 85% or greater.

RESPONSIBILITIES

Maintains complete knowledge of all state, federal, and contracted third party regulations for billing and reimbursement for all payers. Informs Manager of any opportunities available to enhance reimbursement in accordance with billing regulations. Successfully resolves matters with third party payers precluding optimal claim submission with third party payers. Interacts with various departments, exhibiting the knowledge and ability to implement coding rule revisions applicable for claim edit resolutions. Continually reviews billing processes and systems to determine the most effective and efficient methods and systems to ensure work stream success. Drives and implements change as necessary. Monitors bill holds at all sources and ensures timely resolution. Works with other departmental managers in resolve. Reports unresolved issues and concerns impeding the billing process. Provides the Manager with weekly reporting of all bill hold activity by payer by reason including number and value of claims on hold and resolution actions taken to date. Reconciles daily bill transmissions from the host to the clearing house and from the clearing house to the payers. Takes appropriate action to resolve and reconcile any and all transmission variances to ensure all claims are successfully transmitted. Post all payments to accounts that come into the office including paper and electronic. Monitor AR and follow up on all denials received. Is the system “super user” and acts as a resource relative to system application and usage. Alerts Manager of any issues, concerns, and /or negative trends. Attends pertinent seminars, internal and external meetings, and participates in appropriate knowledge resources to ensure up to date knowledge base. Shares obtained information with Business Office and institutional personnel. Complies with patient confidentiality policies for the retention of patient health information, or when handling, distributing, or disposing of patient health information. Performs other duties and special projects as assigned by the Manager.

COMMUNICATIONS

Effectively and timely communicates any and all necessary information and changes relative to the billing processes and procedures both internally and externally as necessary. Develops and disseminates timely, internal and external policies, procedures, and process flows as appropriate.

WORKING CONDITIONS

General office environment

QUALIFICATIONS

Experience in Patient Accounts billing in a Healthcare setting, preferably office setting. Familiarity with healthcare medical terminology and coding. Knowledgeable in the reimbursement and billing guidelines for all major third party and governmental payers; Medicaid, Medicare, HMO’s; Commercial, Worker’s Compensation and Third Party Liability. A combination of education, applicable certification, and experience. HS diploma required. Good communication and interpersonal skills. PC and Microsoft Office Suite use and application literate. Knowledge of billing and patient accounting systems. Analytically inclined.

Pay Range:

$20.00-$24.00/hr Employee salary is based on commensurate experience and other qualifications.

About Oswego Health:

The mission of Oswego Health is to provide accessible, quality care and improve the health of residents throughout Oswego County. As a nonprofit healthcare system established in 1881, Oswego Health is proud to be Oswego County’s largest private employer. More than 1,300 employees spread throughout its 18 locations, work for the Oswego Health system, which includes the 132-bed community Oswego Hospital, a 32-bed psychiatric acute-care facility with multiple outpatient behavioral health service locations, The Manor at Seneca Hill, a 120-bed skilled nursing facility, and Springside at Seneca Hill, an independent retirement community. The health system also operates Oswego Health Home Care, the only hospital-based certified home healthcare agency in the County, as well as two outpatient centers, including the Fulton Medical Center, offering urgent care, lab, medical imaging, physical therapy, and occupational health services, and the Central Square Medical Center, offering urgent care, lab, medical imaging, and physical therapy services. In addition, the healthcare system includes Oswego Health Medical Practice, a multi-specialty medical group offering the community accessible, high-quality healthcare. 100+ physicians and advanced practice providers offer an extensive array of services across CNY, including primary care and specialty care in the areas of orthopedics, cardiology, ENT, gastroenterology, breast care, general surgery, urology, and bariatrics.

EQUAL EMPLOYMENT OPPORTUNITY

Oswego Health is committed to providing equal opportunity in all employment-related matters, without regard to race (including traits historically associated with race), creed, color, religion, sex/gender, national origin, age, marital or familial status, disability, pregnancy-related condition, sexual orientation, gender identity, gender expression, transgender status, citizenship status, ancestry, arrest/conviction record, military or veteran status, domestic violence victim status, genetic predisposition or carrier status, reproductive health decision making, relationship or association with a member of a protected category, or any other legally protected characteristic. Decisions affecting your position including, but not limited to, recruitment, hiring, placement, promotion, transfer, compensation, benefits, training, tuition assistance, leaves of absence, disciplinary action, layoff/recall, and terminations will be made in accordance with this policy.