CCI Health & Wellness Services
  • 02-Jan-2018 to 03-Mar-2018 (EST)
  • Silver Spring, MD, USA
  • Full Time

Position Summary:

 I is seeking a Claims Processing Associate  to process charges for patient encounters, ensure accuracy of demographic and financial information and completion of diagnosis and coding as a pre-requisite to submission of claims for payment from third party payors. The Claims Processing Associate  will assure that the provision of high quality; cost efficient, culturally sensitive services comply with all Federal, State and Local agency policies and procedures.

 

 

Key Functions & Responsibilities:

 

  • Responsible for ensuring E&M Codes are entered into the encounter  as applicable
  • Responsible for ensuring applicable procedures are entered into the encounter in a timely and accurate manner  which may necessitate review of patient record to ensure code is consistent with provider documentation,
  • Review chart and coding to ensure appropriate modifers are assigned, as applicable,
  • In situations where inconsistencies are identified, employee is required to communicate with the provider and coordinate with them to ensure resolution is achieved no later than the end of the calendar month in which services were performed,
  • Review encounters to validate that demographic and financial information is complete and accurate, where applicable and that financial classification (Sliding, Scale, Family Planning, Accurate Insurance, Refugee, BCCP, Self Pay etc) is accurately assigned to the encounter,
  • In situations where inconsistencies are identified, employee is required to communicate with the CBO Coordinator and/or Revenue Cycle Manager,  and coordinate with them to ensure resolution is achieved no later than the end of the calendar month in which services were performed,
  • Responsible for approving accurately completed encounters in a timely manner (within 24 hours of services being provided). All services performed during the month are to be completed and released to billing  by the end of the calendar month
  • Exhibits and promotes a standard of excellence in the performance of all duties and interactions with patients, providers, co-workers and outside contacts.

 

EDUCATION AND EXPERIENCE:

 

  • Requires a High School Diploma with preference for some college.
  • Must have at least two years of relevant work experience  in a medical setting or an equivalent combination of training and experience in order to perform office routines
  • Experience in claims processing and/or accounts receivable management in a medical (Large Physician Practice, hospital clinic or FQHC)
  • Computer skills required. 

 OTHER SKILLS AND ABILITIES:

 

  • Fluency in English and Spanish would be a positive factor
  • Exhibit articulate, professional decorum and verbal and written communications
  • Must possess excellent interpersonal skills in order to appropriately communicate with physician providers, health care professional and management
  • Ability to maintain a high standard of quality, control and observance of corporation protocols in a situations which may arise within an occasionally, hectic environment.
  • Ability to work in a computerized environment with experience in medical claims processing and EMR.
  • Knowledge in medical coding with preference for ability to clearly read and understand medical charts and medical terminology - a plus
CCI Health & Wellness Services
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