Qualifications or Education, Training and Experience

• High School Diploma required
• Minimum 3-5 years’ experience in physician billing
• Experience working in a physician practice preferred
• athenaNet experience preferred
• Detail oriented
• Working knowledge of Microsoft Office Word and Excel

Knowledge and Skills/Expected Competencies

• Knowledge of accounting, healthcare, and general office procedures, preferred.

• Working knowledge of collection processes and insurance verification and pre-certification processes.

• Requires ability to understand, interpret, evaluate, and resolve basic customer service issues.

• Intermediate knowledge of accounting principles which directly impacts the accounts receivable that may include debit and credit transactions; charge transfers; contractual allowances and adjustments and financial class changes.

• Knowledge of the state and federal reimbursement and regulatory guidelines to ensure compliance with State regulations regarding patient and insurance billing issues, preferred.

• Knowledge of medical terminology

• Requires knowledge of common revenue cycle accounts receivable terms, common business practices, and statute of limitations as it pertains to billing, appeals, payer requests, payments, retractions, and EOBs.

• Requires knowledge of billing, collection, and telecommunications software

• Understands HCPC and/or CPT coding issues that could impact a claim.

• Requires knowledge of up to date HIPAA and HITECH rules and regulations.

• Demonstrates ability to assist in mentoring others in regard to the department’s payers and revenue cycle processes.

• Ability to work the receivable of multiple facilities with experience, knowledge, and skills that are transferable to other tasks and assignments.

• Understands common terms used daily in carrying out tasks.