Description
FIRST POSTING TO ENROLLED ONEIDA TRIBAL MEMBERS ONLY
Salary is Negotiable
After successful completion of the probationary period, employee will receive off probation wage increase.
Summary:
This position will perform a variety of clerical and accounting functions for patient billing, including RX claims, verification of invoice information, maintenance of third-party billing records, and resolution of a variety of problems. Follow up on submitted claims and patient billing; resubmit claims or resolve problems. May handle cash items and accounts receivable posting.
Responsibilities:
* Process billing to patients and third-party reimbursement claims; maintain supporting documentation files and current patient demographics.
* Process and file claim to secondary insurance after primary insurance benefits have been processed.
* Process patient statements, key data, post transactions, and verify accuracy of input to reports generated.
* Follow up on unpaid claims, initiate tracers; resubmit claims as necessary.
* May receive and receipt cash and third-party reimbursements; post and reconcile Explanation of Benefits (EOB) payments and adjustments to patient account.
* Balance daily batches and reports; prepare income reports and statistics; distribute reports.
* Generate contractual adjustment document when appropriate.
* Responsible for closing the day's batches.
* Review denied EOB from insurance companies and contact patient and insurance companies to collect missing information and update information on all patient accounts. Interact with external companies and attorneys as needed/required.
* Work the HL7 editor errors for Compulink, QS1, and the lab. Also run claims.
* Process and maintain personal payment information in system, generate a receipt for transactions, to include credit card payments and payroll deductions.
* Answer phone calls from patients and external companies regarding account information on patients.
* File and organize billing paperwork, documents and batches. Box up batches and prepare for Records Department.
* Process reimbursements and refunds as needed/required. Transfer monies deposited into the wrong accounts.
* Perform a variety of general clerical duties, including telephone reception, mail distribution, patient registration and other routine functions.
* Contributes to a team effort and accomplishes related results as required
Skills:
Essential:
* Interact and maintain good professional working relationships with individuals of varying social and cultural backgrounds
* Computerized accounting software programs, office equipment including 10-key adding machine, and word-processing and spreadsheet programs
* Ability to verify data input and correct errors; sort, check, count and verify numbers
* Ability to interact and communicate with people over the telephone, often in stressful situations
* Skill in data entry and word processing
* Knowledge of medical insurance claims procedures and documentation
* Knowledge of AAAHC, HIPAA, Workers Compensation, OSHA, Federal, State and Local regulation, DHS state licensing DHS 35 and DHS 7
* Records maintenance
* Ability to work independently and meet strict timelines
* Ability to sort, check, count and verify numbers
* Must comply with Caregiver Law and Grant conditions criminal history checks as a condition of employment to include fingerprinting
* Ability to demonstrate outstanding customer service at all times.
* Ability to gather data, compile information, and prepare reports
* Ability to use independent judgment and to manage and impart confidential information
* Ability to analyze and solve problems
* Ability to communicate effectively both verbally and in writing.
Education Requirement - Or A Closely Related Field:
Education with Equivalent Qualifications:
Essential:
* General Ed, High School Equivalency Diploma, HS Diploma
* Applicants age 50 and older are exempt from this requirement
* A Combination of Experience and Education May Be Considered
Credentials:
Nonessential:
* Child Abuse Reporting Policy (CARP), within ninety (90) days of employment.
* Health Insurance Portability (HIPAA) Accountability, within thirty (30) days of employment.
Working conditions:
Essential:
* Sit frequently
* Repetitive movement of hands
* Climb heights frequently
* Balance frequently
* Bend/stoop frequently
* Kneel frequently
* Crouch frequently
* Crawl frequently
* Stand frequently
* Walk frequently
* Lift 11-24 pounds continuously
* Move 11-24 pounds occasionally
* Office setting
* Moderate noise level
* Evening and weekend work may be required
* Work extended hours
* Work irregular shifts
* Measles mumps rubella vaccination required
Other information:
EQUAL EMPLOYMENT OPPORTUNITY STATEMENT - The Oneida Nation does not discriminate based on race, color, national origin, sex, religion, age or disability status in employment or the provision of services. However, individuals of Indian ancestry and Veterans will be given preference by law in employment.
Continuation of this position is contingent upon funding allocations.
Must maintain strict security, confidentiality, and quality to meet professional standards of the department.
Must adhere to all Oneida Nation Personnel Policies and Procedures, Oneida Nation Standard Operating Procedures, and Area and Program Strategic Plans and Policies.
Must pass a background check to meet Employment Eligibility Requirements. If applicable, must pass a background check to meet Oneida Nation/State Compact and/or Oneida Nation Gaming Ordinance, and may be required to obtain a temporary license and/or Gaming license as a condition of employment.
Must be willing and able to obtain additional related education and training.
Must pass a pre-employment drug screen and adhere to the Nation Drug and Alcohol-Free Workplace Policy.
A Tuberculosis (TB) Screening and/or a 2 step TB Skin Test is required within thirty (30) days of employment.
Must provide a copy of diploma/degree, license, or certification upon employment.
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