Lead Medical Biller

This position is currently open.

Public?: 

Public

Division: 

Health

Reports To: 

Director of Finance

Type of Position: 

Full-Time (Hourly)

Location: 

Little Axe Health Center / 15951 Little Axe Dr. / Norman, OK 73026

General Description

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 Team leader as a charge entry billing specialist. This position oversees 2 billing specialist staff members 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 coding errors including adjustments and denials. Three years of work experience in a related field is necessary.
 
 

 Responsibilities

1. Oversee the day-to-day functions for a group of 2 billers which consist 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 the Medical Lead Coder, 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. Assist the coding and compliance team with the procedure manuals related to coding and billing compliance. 
9. Train new and current Billing Specialist on billing, claim charges and coding process.
10. Generate Excel spreadsheets for special projects as assigned.
11. Performs coding validation to ensure that the diagnoses/procedures submitted on the claim are supported by the clinical record documentation and appropriate billing by contact.
 
12. Ensure codes are accurate and sequenced correctly in accordance with government and insurance regulations.
 
13. Other duties as assigned
 

 Education Requirements and qualifications

 
  • High School Diploma with 5 to 10 years of experience or Associates degree with equivalent with 2-4 years of experience in medical billing or medical data entry.  
  • CPC-(Certified Professional Coder) or the ability to obtain certification within six (6) months of hire.
  • CPB-(Certified Professional Biller) or 5 to10 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
 
 

Posted Date: 

6 days 19 hours ago
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