To provide support for all aspects of professional/departmental billing and/or financial accounting for a Medical Center dedicated to the care of infants, children and adolescents. To serve as a resource and role model for the department/division.
Position is essential to ensure collectability of traditional Medicaid benefits for home HME services to patients in obtaining required authorizations within appropriate time limits Handles obtaining authorizations for Home Health HME items from traditional Medicaid payors for OH, KY, IN and out of area Medicaid plan.
Act in manner that maintains confidentiality, protects and safeguards patient/family personal medical and financial information at all times during collection, use and storage. Access only information and records necessary to perform the responsibilities of your position.
Compile and prepare customer charges. Prepare invoices, indicating individual line items for services and total costs. Review and post data. Review computer printouts to ascertain monthly costs, schedule of services completed and type of services performed. Obtain and evaluate family, third party payors and agency resources for payment of charges. Counsel patient on third party coverage and present financial aspects. Determine eligibility for State Medicaid, Social Security and other outside funding. Complete necessary paperwork for eligible patients, including medical and financial applications. Coordinate inpatient and outpatient admissions. Coordinate information with the inpatient and outpatient charge systems. Input charges and relative information. Manage accounts receivable data and collection information, ensure timeliness and accuracy. Research third party payors and community physician charges in order to maintain 'usual and customary' as will as competitive charges. Check and update charge master. Conduct utilization review for the division from insurance companies and working in conjunction with Cincinnati Children's Utilization Review department.
Serve as a liaison between Physicians Billing Service, Admitting, Outpatient Surgery, Outpatient Department, Patent Financial Services and other Cincinnati Children's departments.
Provide Quality Assurance reports for the division. Maintain and update departmental system, including templates and payor and physician information.
·Act as a Department Resource
Act as a preceptor for new employees. Perform specialty services functions. Act as a resource within the department/division. Provide instruction for performing non-routine functions.
Skills & Competencies
Using time efficiently and productively; prioritizing multiple tasks properly to meet deadlines; recognizing time constraints and adjusting work schedule to address them.
Understanding and showing respect and appreciation for the uniqueness of all individuals; leveraging differences in others' perspectives and ideas; appreciating cultural differences and adjusting one's approach to successfully integrate with others who are different from oneself
Knowledge of ICD-9/10 and CPT Coding
Proficiency in basic computer applications such as Microsoft Office (Word, Excel, Access), e-mail, and internet
Knowledge of, and the ability to operate, standard office equipment such as computers, telephones, copiers, etc.
Meticulously keeping track of details without becoming overwhelmed by them; being exacting, precise, and accurate; spotting minor imperfections or errors and taking action to correct them
·Independence and Teamwork
Ability to work both independently and in a team environment
Ability to independently work through details of a problem to reach a positive solution
Effective verbal, written and/or interpersonal communication skills
Knowledge of medical terminology
·High School Graduate OR equivalent
·2 years of experience in a medical setting OR Bachelor's Degree in a related field Preferred:
·Billing & collections experience