Little Axe Health Center / 15951 Little Axe Dr. / Norman, OK 73026
This position is located at the Absentee Shawnee Tribal Health System in Little Axe, Oklahoma within the Health Business Office. 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 medical billing is responsible for ensuring accurate billing, timely submission of electronic and/or paper claims, monitoring claim status, researching rejections and denials, documenting related account activities, and collections of Medicare, Medicaid, Medicaid Managed Care, and commercial insurance payers. The medical billing must possess critical thinking skills and understanding of Medicare, Medicaid eligibility requirements as well as commercial insurance payer payment methods to correctly record contractual adjustments base on payer contracts or government regulations. In addition, the medical billing specialist must demonstrate proficiency with billing system to ensure all functionality is utilized for the utmost efficient processing of claims.
Responsible for charge entry within eClinicalWorks. Coordinates and clarifies with providers, when necessary, on information that seems incomplete or is lacking for proper account/ claim adjudication
Responsible for correcting, completing, and processing claims for all payer codes
Analyze and interpret that claims are accurately sent to insurance companies
Perform follow up with Medicare, Medicaid, Medicaid Managed Care, and Commercial insurance companies on unpaid insurance accounts identified through aging reports
Process appeals online or via paper submission
Assist with billing audit related information
Process refund requests
Communicate with Lead Biller and Sr. Credentialing Specialist to identify and resolve audit review issues
Process billing calls and questions from patients and third party carriers
Answer/respond to correspondence related to patient accounts. Is available to answer billing and changes related inquiries by patients, staff, Medicare, Medicaid, Managed Care, and Commercial insurance companies, etc.
Communicate daily with internal and external customers via phone calls and written communications
Identify trends, and carrier issues relating to billing and reimbursements. Report findings to Revenue Integrity Officer and Compliance Officer, record findings, and communicates effectively with the Revenue Integrity Officer and Compliance Officer to achieve optimum performance
Pursue and participate in education to remain current with changes in the Healthcare industry
Maintain patient confidence and protects medical office operations by keeping patient information confidential
Contribute to team effort by accomplishing related results as needed
Promote effective working relations and work effectively as part of a team to facilitate the department’s ability to meet its goals and objectives
Demonstrate respect and regard for the dignity of all patients, families, visitors, and fellow employees to insure a professional, responsible and courteous environment
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.
Assists with monthly statement process, to include reviewing statements and field any patient inquiries the Patient Services staff needs to escalate.
Coordinate collection process, to include any projects and tracking current collections in eClinicalWorks.
Work with Registration staff to ensure appropriate collection of co-pay and insurance information.
Perform 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.
Physical Requirements and Working Conditions
Must be able to sit, stand, stoop, bend or kneel for long periods of time.
Sitting or standing or walking for long period of time; occasional bending, squatting, kneeling, stooping; good finger dexterity and feeling; frequent repetitive motions; talking hearing and visual acuity.
Frequent lifting (up to 15 lbs)
Occasional lifting (up to 30 lbs)
Native American Preference/EEO/Smoke Free/Drug Free Workplace
2 months 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