Little Axe Health Center / 15951 Little Axe Dr. / Norman, OK 73026
This position is located at the AST Li Si Wi Nwi Clinic in Little Axe, Oklahoma within the Health Finance department. The Little Axe Health Center is a new facility that serves Absentee Shawnee Tribal members as well as other Native American and Non-native American Sooner Care patients. The purpose of this position is to abstract and code patient’s medical record, according to state and federal rules and regulations that will help process third party billing. Medical Billing Office seeking a Fulltime Medical Biller as a charge entry billing specialist. This position will process claims and requires substantial experience and understanding of the healthcare billing industry including ICD-10 + CPT coding. Responsibilities entail capturing patient demographics from 2 clinic facilities, entering, reviewing and preparing patient and insurance data into e-clinical works system, researching and verifying accuracy of billing data and the revision of billing errors including adjustments and denials. Three years of work experience in a related field is necessary.
1. Prepares and submits clean claims to third party payers either electronically or by paper which consists of Shawnee and Little Axe medical services, wound care, Optometry, Dental and Physical therapy, Behavioral Health charge entry.
2. Responsible for reviewing patient logs, demographic, insurance eligibility and other activity to ensure billing is captured for all patients and completed accurately.
3. Safeguards confidentiality of the medical charts/electronic health records and complies with all local, state, and federal laws pertaining to medical records. Assures compliance with all HIPAA regulations concerning use, retrieval, storage, and sharing of medical records.
4. Monitor Insurance electronic claim billing process is completed successfully on a daily basis.
5. Report billing discrepancies to Lead Medical Biller, Health Financial Officer and Revenue Integrity Manager.
6. Stay up-to-date on current coding and billing regulations and departmental policies.
7. Assist with third party payer and other audit request, by compiling and organizing documentation.
8. Handles patient inquiries and answers questions from clerical staff and insurance companies, identifies and resolves patient billing problems.
9. Assists with monthly statement process, to include reviewing statements and field any patient inquiries the Patient Services staff needs to escalate.
10. Coordinate collection process, to include any projects and tracking current collections in eClinicalWorks.
11. Coordinate the process of patient eligibility through various third party sources and issues adjusted, corrected, and/or rebilled claims to third party payers.
12. Work with Registration staff to ensure appropriate collection of co-pay and insurance information.
13. Other duties as assigned.
Education Requirements and qualifications
High School Diploma with 2-4 years of experience in medical billing or medical data entry.
CPB-(Certified Professional Biller) or 2 to5 year experience.
Documented training and experience in maintenance of medical records and ICD-10-CM/DRG coding.
eClinical works E H R systems experience is preferred.
Knowledge, Skills and Abilities
A working knowledge of medical terminology and physiology and legal aspects of health information
Knowledge of accreditation standards and compliance requirements.
Must have knowledge of or experience in working with third party resources such as Medicare, Medicaid and Private Insurance, Contract Health or Coordination of Benefits, medical records, and patient registration.
Must be reliable, detailed oriented, capable of multi-tasking with excellent written and verbal communication skills as well as strong professional customer- service interpersonal skills.
Ability to communicate effectively orally and in writing; ability to relate well with co-workers and the general public.
Ability to adjust to changing conditions.
Must be computer literate required (Windows operating systems – Microsoft Word, Excel).
Must have a valid Driver’s License
Must be able to pass a background check and drug screen.
Native American Preference/EEO/Smoke Free/Drug Free Workplace
1 month 2 weeks ago
Tribal Preference/Native American Preference/EEO/Smoke Free/Drug Free Workplace Indian preference applies to all positions, but all resumes will be accepted.
Forward Completed Absentee Shawnee Tribe applications with resume to: Absentee Shawnee Tribe Human Resources Department 2025 South Gordon Cooper Dr. Shawnee, OK 74801 Fax: 405-273-2710 Email: HR@astribe.com