Alaska Native Tribal Health Consortium
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Principal Medical Billing Specialist - Full Time - Bussiness Office
at Alaska Native Tribal Health Consortium
Under general supervision, prepares and submits insurance claims; reviews and adjusts accounts to ensure accurate and thorough billing of claims; monitors and ensures timely payment of bills. Develops and tests new billing procedures.
Develops and tests new billing procedures. Assists in implementation of new office processes.
Determines billable claims and submits insurance claims. Tracks and monitors claim processing, resolving outstanding claims. Completes insurance data for patient claims; processes, researches and corrects accounts to verify diagnosis and authorization codes.
Identifies liability and guarantors; reviews and adjusts account balances; interprets Explanation of Benefits (EOBs); analyzes billing components.
Verifies all identified insurance carriers for eligibility; confirms carrier policy. Reviews claims before submission to insurance carrier; assesses adjudicated claims.
Posts payments and adjustments in billing databases; prepares batches for posting. Creates, organizes, corrects, updates and maintains accounts on data spreadsheets using medical billing software. Assists in decision making processes regarding data.
Ensures correct and prompt claims payments through confirmation from providers, maintaining strong knowledge of billing system software, master files and interface conversion tables.
Trains and mentors staff. Assists in monitoring of staff in training and beyond. Takes lead on special projects as assigned to assure completion. Assists in distributing workload among coworkers; provides assistance to coworkers; monitors and reviews coworkers'' progress. Acts as a backup to cover multiple positions in office.
Provides assistance to patients, carriers, and other external parties.
- Knowledge of medical billing and accounting procedures and applications.
- Knowledge of claims review, analysis and quality assurance.
- Knowledge of commercial insurance and government reimbursement programs.
- Knowledge of basic medical terminology and clinic processes.
- Knowledge of reception, typing, computer operations, and filing.
- Skill in operating a personal computer using a variety of software including medical billing applications.
- Skill in tracking and accomplishing multiple tasks and assignments.
- Skill in establishing and maintaining cooperative working relationships with other employees.
- Skill in conducting successful telephone consultations and operating a multi-line office phone system.
An Associate''s Degree in business, finance or related discipline. Progressively responsible related work experience may be substituted on a year-for-year basis for college education.
Non-supervisory - Seven (7) years of experience working in a medical office performing medical billing processes. An equivalent combination of relevant education and/or training may be substituted for experience.
This position requires the ability to sit for long periods of time. ANMC is not a latex free environment. Therefore, some latex exposure can be expected.