Sac and Fox Tribe of Iowa
  • 11-Sep-2017 to 29-Sep-2017 (CST)
  • Tama, IA, USA
  • Hourly
  • Full Time

Health, Dental, Vision, 401(k), Accident Insurance, Cancer Insurance, Flex Dependent & Flex Non-Reimbursed Medical.


DEPARTMENT: Health

CLASSIFICATION: Non-Exempt

DUTIES & RESPONSIBILITIES:

  • Responsible for editing claims for all lines of business
  • Determine appropriate collection action by processing accounts in assigned work queues claims.  
  • Responsible for collection follow-up on claims for outpatient clinic, pharmacy and dental office.
  • Review accounts to ensure compliance with applicable local, state, and /or federal law and regulations
  • Responsible for gathering information, making recommendations related to adjustments of uncollectible balances and completing accounts appropriately
  • Identify accounts which require refunds, calculate refund amounts, and refer accounts to supervisor for approval.
  • Respond timely to incoming correspondence and telephone calls from patients, guarantors, third parties, attorneys and other departments regarding accounts.
  • Interpret benefits, exclusions and accurate reimbursement levels of primary and secondary insurance coverage.
  • Responsible for electronic/paper claim submittal and interface between Meskwaki Clinic and external entities.
  • Utilize documentation (e.g., settlement draft, settlement release) to ensure maximum case settlement.
  • Responsible for posting payments, adjustments, denials, processing appeals, changing financial classes.
  • Communicate with variety of insurance companies via telephone for revenue capture.
  • Responsible for creating and maintaining tickler system for claim follow-up.
  • Identify and resolve patient bill complaints.
  • Verify coordination of benefits with all carriers; Medicaid, Medicare, Veterans Administration, private insurance, Workers' Compensation, Third Party liability.
  • Update computer system with pertinent information regarding other insurance coverage and third party liability cases including workers' compensation.
  • Verify and gather additional data to avoid claim denials.
  • Initiate interdepartmental paper and electronic inquiries.
  • Maintain strictest confidentiality; adheres to all HIPAA guidelines/regulations.
  • Meet productivity goals established.
  • Other duties as assigned.

REQUIREMENTS:

  • Combination of education and/or experience in Outpatient or Inpatient healthcare setting. 
  • Education: Associates Degree Health Information Management or related field or Coding certification through AHIMA or AAPC
  • Experience: At least 5 years Outpatient/Inpatient Collector and/or Patient Account Representative.
  • Prefer electronic health record and practice management experience. Prefer knowledge of billing requirements, to include, but not limited to: ICD-9, CPT, fee schedule allowances and reductions, calculations necessary for account management
  • Proficient in business specific billing and collection rules, regulations and other pertinent payer specific requirements
  • Excellent customer service skills
  • Self-motivated and detail-oriented
  • Ability multi-task and troubleshoot
  • Possess strong computer skills
  • Must be sensitive to the Tribal customs and health needs of the Tribe
  • Must submit to and successfully complete background investigation

SUPERVISION:

  • Supervised by the Director of Administrative Services

SALARY LEVEL:

  •  Annual Salary: $29,203.20 - $40,851.20
Sac and Fox Tribe of Iowa
  • Apply Now

    with our quick 3 minute Application!

  • * Fields Are Required

    What is your full name?

    How can we contact you?

    By clicking the button above, I agree to ApplicantPro's Applicant Information Use Policy.

  • Sign Up For Job Alerts!

  • Share this Page
  • Facebook Twitter LinkedIn Email
.
Logo Government Membership About Us News Events Enterprise Community Services FB