Billing Associate I

Summary

Genesis Healthcare System is committed to providing compassionate, exceptional, and affordable healthcare services to its community. The Billing Associate I bills commercial payer accounts accurately and compliantly, resolves billing issues and denials, and supports timely reimbursement. The role also responds to patient inquiries and works with payers, physician offices, and internal departments.

Responsibilities

• Interprets reports accurately and works requested reports within time frame established
• Utilizes all online technology and bills accounts electronically when possible based on availability and payer guidelines
• Ensures all claims and processes are compliant with the rules and regulations of our government and third party payers
• Follows appropriate guidelines for billing and follow up of accounts
• Appeals accounts if denied due to billing related issue
• Will ensure that accounts are properly corrected both on hospital system as well as government payer system when applicable (Medicare online-MITS)
• Works rejections/denials and work list timely to prevent timely write off’s
• Bills secondary accounts timely when applicable
• Checks payer websites subscribes to list serves where applicable and is accountable to obtain necessary information from the payer/website. Uses information from website and other sources accurately and effectively
• Works recoupment accounts according to instructions for specific recoupment projects and is timely in response
• Enters denial information in the Denial System to accurately track all accounts that are not paid as expected
• Notifies appropriate person/department to provide information for accounts that error for CCI edits and handles accordingly
• Contacts medical records as necessary (i.e. diagnosis, coding, etc)
• Will be responsible for consecutive work-queues to ensure the accounts are being billed according to payer guidelines
• Performs other functions as assigned
• Performs work in a manner that is quality focused
• Treats patients, co-workers, visitors and volunteers with courtesy, compassion, empathy and respect
• Results oriented and focused on achievement of objectives
• Acknowledges and responds to the diversity of people and the situation
• Encourages peers (others) to be owners of change
• Always makes the effort to anticipate and exceed customer needs and expectations
• Possesses the ability to engage others with patience and understanding
• Acts in a manner that creates positive first and lasting impressions
• Demonstrates the ability to own issues until they are resolved
• Introduces self and role…connects with everyone
• Communicates effectively (i.e. advising others of actions, pertinent information, time durations, etc.) and asks for feedback
• Asks for and anticipates needs and concerns of others
• Maintains a positive work environment for staff and a healing environment for patients (i.e. safe, clean, quiet, etc.)
• Maintains the dignity and privacy of each person; manages confidential/sensitive information appropriately
• Responds to requests in an appropriate and timely manner
• Exits patient/customer encounters courteously, asking if there are additional needs that can be addressed
• Demonstrates safe Patient Handling (i.e. transfers, transport, care administration, nutrition, medication, etc.)
• Demonstrates safe Materials Handling (i.e. appropriate use and disposal of chemicals, infectious wastes, etc.)
• Demonstrates appropriate knowledge of Infectious Disease precautions and use of proper protective equipment
• Demonstrates Slips/Trips and Falls Awareness
• Actively contributes to maintaining a safe, clean and quiet environment

Skills

• High school diploma or equivalent
• Experience with healthcare insurance and/or government billing
• Knowledge of Medicare/Medicaid billing reimbursement policies
• Some knowledge of CPT and ICD 9/ICD 10 Codes
• Knowledge and understanding of insurance denials and explanation of benefits
• Excellent listening, verbal and written communication skills, with ability to deal occasionally with disgruntled individuals
• Excellent interpersonal, decision-making, facilitation, conflict resolution and investigative skills
• Ability to independently prioritize and focus on multiple tasks concurrently
• Ability to work independently and under pressure in a complex and changing working environment
• Ability to work effectively with physician offices, staff from hospital departments or any resource for denial resolution
• Effective time management and organizational skills
• Excellent computer skills and knowledge of computer software, including programs such as Word, Excel

Qualifications

Must Haves

• High school diploma or equivalent
• Experience with healthcare insurance and/or government billing
• Knowledge of Medicare/Medicaid billing reimbursement policies
• Some knowledge of CPT and ICD 9/ICD 10 Codes
• Knowledge and understanding of insurance denials and explanation of benefits
• Excellent listening, verbal and written communication skills, with ability to deal occasionally with disgruntled individuals
• Excellent interpersonal, decision-making, facilitation, conflict resolution and investigative skills
• Ability to independently prioritize and focus on multiple tasks concurrently
• Ability to work independently and under pressure in a complex and changing working environment
• Ability to work effectively with physician offices, staff from hospital departments or any resource for denial resolution
• Effective time management and organizational skills
• Excellent computer skills and knowledge of computer software, including programs such as Word, Excel