Clerk Biller - Riverside Medical Center : Job Details

Overview

St. John's Riverside Hospital is a leader in providing the highest quality, compassionate health care utilizing the latest, state-of-the-art medical technology. Serving the Westchester community from Yonkers to the river town communities of Hastings-on-Hudson, Ardsley, Dobbs Ferry and Irvington, St. John's Riverside has been and continues to be a unique and comprehensive network of medical professionals dedicated to a tradition of service that spans generations.

St. John's has been an integral part of the community since the 1890's and its' commitment to provide the community with the most advanced medical services available continues to be the hospitals' vision, mission and value. St. John's Riverside Hospital built itself around an early foundation of nursing and community service. In 1894, the Cochran School of Nursing, the oldest hospital-based school of nursing in the metropolitan area, was founded, thus making the St. John's Nursing Staff more than just the backbone of the hospital, but the heart and soul. St. John's dedicated nurses give superior attention to those who need it most with a strong emphasis on patient and family-focused nursing care.

St. John's Riverside Hospital staff is committed to making life better for all patients. The hospital continues to elevate the services provided with the goal of increasing the quality of life for all who entrust St. John's Riverside Hospital to their care.

Personalized care together with advanced technology is what it means to be Community Strong

Responsibilities

The Medical Biller reviews patient account files and ensures accuracy of charges and insurance to determine appropriate billing and payment; monitors outstanding accounts; Processes adjustments and refunds on paid accounts. Claims corrections using Meditech/Omnipro /EPaces/Emdeon; receives and answers billing-related inquiries; and assists in the preparation of billing reports.

Reviews patient account files and ensures accuracy and timely submission of all documents. Possesses good computer and keyboarding skills. Identifies charges and payment responsibility as it pertains to primary, secondary and tertiary coverage. Identifies any patient co pays and coinsurance responsibility. Maintains statuses of open accounts, expected receipts and pending accounts, following up by phone, internet, mail and fax. Refers any overdue problem accounts to credit counselors or collections. Required to maintain all follow up notes, information or updates in the patient's account file. Ensures that proper documentation is provided from the Medical Records department for required billing and reviews, monitors any medical record request from Medicare or insurance carriers for timely submission. Understands Insurance contracts and calculates expected reimbursement. Retrieves daily Payment logs, verifies payments have been applied properly and posts related adjustments. Identifies and processes refunds to insurance companies for overpaid accounts. Processes any Adjustments using the Meditech System, Omnipro, Emdeon and/ or EPACES. Knowledgeable in billing practices including standard codes sets (HCPCS, CPTS & ICD-9 coding, UB 04 & 1500 forms, 837 and 835 requirements). Stays informed about changes in Medicare and Medicaid. Assists in preparation of billing reports, prepares and maintains billing files and records.Responds to and meets with auditors in a knowledgeable manner.

Qualifications

HS Diploma or equivalent, some college preferred. 1 year of medical billing experience preferred. Knowlege of medical billing and collection practice required. Knowledge of Acute Care Facility Billling prefered. Knowledge of basic medical coding and third party operating procedures and practice required. Strong pc experience including MS office - Word, Excel. Excellent writing and communciations skills.