Biller- Patient Financial Services
Company: Baton Rouge General Medical Center
Location: Baton Rouge
Posted on: January 24, 2023
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Job Description:
Now offering a $2,500 sign-on bonus to experienced and qualified
applicants.
JOB PURPOSE OR MISSION: To analyze and follow up outstanding
account balances and establishing acceptable payment
arrangements.
PERFORMANCE CRITERIA
CRITERIA A: Everyday Excellence Values - Employee demonstrates
Everyday Excellence values in the day-to-day performance of their
job.
PERFORMANCE STANDARDS:
* Demonstrates courtesy and caring to each other, patients and
their families, physicians, and the community.
* Takes initiative in living our Everyday Excellence values and
vital signs.
* Takes initiative in identifying customer needs before the
customer asks.
* Participates in teamwork willingly and with enthusiasm.
* Demonstrates respect for the dignity and privacy needs of
customers through personal action and attention to the environment
of care.
* Keeps customers informed, answers customer questions and
anticipates information needs of customers.
CRITERIA B: Corporate Compliance - Employee demonstrates commitment
to the Code of Conduct, Conflict of Interest Guidelines and the GHS
Corporate Compliance Guidelines.
PERFORMANCE STANDARDS
* Practices diligence in fulfilling the regulatory and legal
requirements of the position and department.
* Maintains accurate and reliable patient/organizational
records.
* Maintains professional relationships with appropriate officials;
communicates honesty and completely; behaves in a fair and
nondiscriminatory manner in all professional contacts.
CRITERIA C: Personal Achievement - Employee demonstrates initiative
in achieving work goals and meeting personal objectives.
PERFORMANCE STANDARDS
* Uses accepted procedures and practices to complete assignments.
Uses creative and proactive solutions to achieve objectives even
when workload and demands are high.
* Adheres to high moral principles of honesty, loyalty, sincerity,
and fairness.
* Upholds the ethical standards of the organization.
CRITERIA D: Performance Improvement - Employee actively
participates in Performance Improvement activities and incorporates
quality improvement standards in his/her job performance.
PERFORMANCE STANDARDS
* Optimizes talents, skills, and abilities in achieving excellence
in meeting and exceeding customer expectations.
* Initiates or redesigns to continuously improve work
processes.
* Contributes ideas and suggestions to improve approaches to work
processes.
* Willingly participates in organization and/or department quality
initiatives.
CRITERIA E: Cost Management - Employee demonstrates effective cost
management practices.
PERFORMANCE STANDARDS
* Effectively manages time and resources
* Makes conscious effort to effectively utilize the resources of
the organization - material, human, and financial.
* Consistently looks for and uses resource saving processes
CRITERIA F: Patient & Employee Safety - Employee actively
participates in and demonstrates effective patient and employee
safety practices.
PERFORMANCE STANDARDS
* Employee effectively communicates, demonstrates, coordinates and
emphasizes patient and employee safety.
* Employee proactively reports errors, potential errors, injuries
or potential injuries.
* Employee demonstrates departmental specific patient and employee
safety standards at all times.
* Employee demonstrates the use of proper safety techniques,
equipment and devices and follows safety policies, procedures and
plans.
JOB FUNCTIONS
ESSENTIAL JOB FUNCTIONS include, but are not limited to:
1. Processes claims populating into Ambulatory Claims Manager
(ACM)
PERFORMANCE STANDARDS:
* Resolve Invalid and Rejected Claims populating into the list
within 5 days.
* Documents the system with notes on current status received and
takes appropriate action.
* Refers delinquent responses and new denials to management.
2. Processes hard copy claims for payment
PERFORMANCE STANDARDS:
* Obtains Explanation of Benefits (EOBs) for coordination of
coverage to attach to Subsequent claims to Secondary and Tertiary
carriers.
* Reviews claim for timely filing guidelines, fee schedule
reimbursement, etc prior to mailing claims
* Refers any issues to management.
3. Maintains Practice Responses to communications
* Creates and responds to RAI (Request for Additional Information)
and/or Spreadsheet
* Monitors any lack of responses
* Refers any issues to management
4. Special projects
PERFORMANCE STANDARDS:
* Receives and resolves "unable to bill" claims by reviewing the
system for copy of insurance card, correct address, policy number
and phone number of insurance carrier for Hospitalist Group
* Investigates any reports delivered by management to monitor
denials
5. Performs all other duties as assigned.
EXPERIENCE REQUIREMENTS
Prior experience in all phases of Business Office operations and
Insurance Collections
EDUCATIONAL REQUIREMENTS
High School Diploma or GED preferred.
SPECIAL SKILL, LICENSE AND KNOWLEDGE REQUIREMENTS
Must have excellent understanding and knowledge of Commercial
Insurance.
HIPAA REQUIREMENTS:
Maintains knowledge of and adherence to all applicable HIPAA
regulations appropriate to Job Position including but not limited
to: paper medical record without limitation, patient demographics,
lab results, patient financial and 3rd party billing information,
patients related complaints, information related to patient
location.
SAFETY REQUIREMENTS:
Maintains knowledge of and adherence to all applicable safety
practices appropriate to Job Position including but not limited to:
incident reporting, exposure control plan, hand washing for all age
groups.
Keywords: Baton Rouge General Medical Center, Baton Rouge , Biller- Patient Financial Services, Accounting, Auditing , Baton Rouge, Louisiana
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