Job Summary:

Maintains, reviews for accuracy and posts payments to respective accounts receivable for Health and Wellness Center.

Essential Functions:

• Upload and reviews all electronic collections, verify with finance received deposits.
• Receives logged checks from payers.
• Batches and posts each payment to the respective accounts
• Balances each batch to all receipts
• Responds to complex third party carrier requirements on post-payment reviews and denials.
• Processes items in the suspense file, researching unpaid claims and resubmitting
• Establishes payment arrangements for self-pay patients, as needed.
• Assists with monitoring daily collections and receipt reports.
• Fields inquiries from patients regarding statements or bills
• Maintain patient/client insurance file, check eligibility and ID numbers and sequencing on a daily basis.
• Prints claims for all GRHWC clinics to secondary insurers, attaching appropriate documents and sending to respective carriers on a weekly basis.
• Ensures collections reconcile to computer generated reports on a weekly basis.
• Insurance/aging follow up on a monthly basis
• Track, monitor and report billing processed adjustments. Tracking denial trends and resolving issues.
• Reviews and prepares various State reports for reimbursement
• Keeps current with best practice options available and recommending to improve practice related operations
• Attends practice management and electronic medical record support staff meetings
• Performs a variety of other duties as assigned by supervisor.

Education, Experience, and Licenses:

• High school diploma or GED and 2 years of specialized job skills training in secretarial and accounting principles or 2 years of work experience in an increasingly responsible position in an accounting departments or medical billing field OR equivalent combination of education, training and experience.
• Minimum of at least 1 year work experience in medical terminology and ICD-10 coding preferred

Qualifications, Registrations, and Certifications:

• Requires a working knowledge of practice management systems and medical billing
• Requires good written and oral communication
• Must maintain a valid Oregon driver's license or obtain one upon hire, qualify for the Tribe's vehicle insurance and provide proof of personal vehicle insurance.
• Must be able to operate standard office equipment such as fax machine, copy machine, visa machine, 10-key by touch, and multi-line telephone
• Requires knowledge of accounting principles and practices
• Must have knowledge of computer software such as Microsoft applications and spreadsheets.
• Knowledge of ethical and legal requirements and restrictions pertaining to the maintenance of billing records, as well as facility policies, HIPAA and other federal regulations.
• Knowledge of and sensitivity to Native American culture required.

Environmental Factors and Conditions/Physical Requirements:

• Continually requires the ability to express or receive detailed information or important instructions through oral communication.
• Continually requires working with fingers rather than the whole hand or arm. Requires repetitive movement of wrists, hands and/or fingers.  Often requires walking or moving about to accomplish tasks.
• Requires standing and/or sitting for sustained periods of time, raising objects from a lower to a higher position and/or moving objects horizontally.
• Occasionally requires lifting of up to 20 pounds.
• Due to the nature of the interactions with other employees and the public we serve, employees may be required to provide documentation of, or receive, certain health vaccinations.
• This position is frequently subject to inside environmental conditions which provide protection from weather conditions, but not necessarily from temperature changes, and is occasionally subject to outside environmental conditions.
• May be called upon to serve as a Disaster Reservist during Emergencies, or when the Tribal Emergency Operations Center is opened.
• Local travel is occasionally required. Travel outside of the state is infrequently required. 

Background Check:

• Candidates for this position will be subject to criminal and character background checks and may be subject to fingerprinting.

Disclaimer:

The individual must perform the essential duties and responsibilities with or without reasonable accommodation efficiently and accurately without causing a significant safety threat to self or others.  The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification.  They are not intended to be construed as an exhaustive list of all responsibilities, duties and/or skills required of all personnel so classified.