CovenantHealth

Job Information

Covenant Health Associate Billing and Collections Representative - Lonestar CBO in Lubbock, Texas

Description

Covenant Health is seeking a Full-time, Day Shift Claims Processing and Billing Rep with the Lonestar CBO Department at Covenant Medical Group.

Apply Today! Applicants that meet qualifications will receive a text with some additional questions from our Modern Hire system.

Job Summary:

Under the direction of the Central Business Office Director and the direct supervision of the Manager and/or Supervisor, the Associate Billing and Collections Representative is responsible for ensuring correct coding initiatives are met for clean claim submission and correction of claim billed and collected on behalf of Covenant. This individual addresses claim edits, files all claims on either a UB-04 (RHC) or 1500 (835/837 file formats) and completes follow-up on outstanding accounts. In addition, this individual identifies functional issues and reports them to the appropriate leader.

Associate Billing and Collection Representatives are responsible for all billing and collection activities in an ethical and compliant manner.

Essential Functions:

  • Bill all primary claims on most appropriate management system (the electronic billing system) or prints to paper, if appropriate, with necessary edits to ensure compliant billing practices. Report any variances in workload to the Director, Manager or Supervisor.

  • Review encounters and/or claims for accuracy and completeness, collecting and verifying all documentation necessary for timely billing of patient accounts, including requesting and collecting medical records and other documents ensuring the acceptance of the claim.

  • Work all reports related to billing, such as work lists, hold reports, no activity reports and rejection reports to ensure claims are submitted timely and accurately per department guidelines.

  • Identify recurring errors and corrections being made to claims and report these to management. Make recommendations to resolve problems.

  • Complete all secondary billing and rebilling. Ensures required attachments, such as remittance advices or explanation of benefit forms are appropriately attached, if required.

  • Resolve rejected claims and perform rebilling as needed.

  • Accurately document actions taken in the system of record to drive effective follow-up and ensure an accurate audit trail.

  • Maintain ongoing knowledge of Medicaid, Medicare, and all other applicable party billing requirements and payer guidelines. Keep current with knowledge of payer billing and coding guidelines. Understand billing timelines and urgency in meeting all claims and filing deadlines.

  • Complete account follow-up based on preset follow-up guidelines based on payor type and account balance; ensure that all activities related to PB collection functions meet department requirements, maximize revenue collection, and achieve leading practice levels of performance:

  • Verify claim is received by all payers timely in accordance with the timely filing limits of the contractual agreement and/or state regulations.

  • Monitor accounts receivable daily through work lists and check claim status through payor claims department or online to ensure proper claims processing.

  • Complete periodic payor phone calls to confirm claim status and drive claim resolution as dictated by department collections policies.

  • Document follow-up activity or pertinent notes (e.g., date of receipt, reference number) within PMS to track and record overall claim process history.

  • Submit any necessary documentation to support claim processing if required by the contractual agreement, payor guidelines, or state laws.

  • Report any critical account issues or barriers in the collections process to direct reports.

  • Trend and document ongoing payor issues and notify management.

  • Daily focus on attaining productivity standards, recommending new approaches for enhancing performance, and productivity when appropriate.

Minimum Position Requeirements

Experience:

  • Experience in computer applications.

Preferred Position Qualifications:

Experience:

  • 1 year Health care business office experience or related field.

  • 3 years Medical billing and medical terminology.

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our mission of caring for everyone, especially the most vulnerable in our communities.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

Requsition ID: SR362785
Company: Covenant Jobs
Job Category: Billing/Collections
Job Function: Revenue Cycle
Schedule: Full time
Shift: Day
Career Track: Admin Support
Department: 8002 ADMINISTRATION LONESTAR CBO
Address: TX Lubbock 2215 Nashville Ave

Covenant Health is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

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