This is a non-supervisory position. Duties include: upload claims, correction or manual entry of claims, download claims responses and claims rejects, the research of rejected, suspended and recouped claims, and the preparation of all subsequent general ledger journal entries to the accounting system; Competently use all software required to complete the billing process from the creation of the outbound file or manual entry claims to the receipt of payment or decision to write off the claim is made; Primary software systems used is Netsmart EHR, FMS, Claim MD clearing house, Texas Medicaid and Healthcare Partnership (TMHP), Service Authorization System Online (SASO – a HHSC website), with a special emphasis on Microsoft Excel; Assist in reconciliation process for each billing cycle; Function as resource person for departmental personnel to answer questions and assists with problem resolution; Assist with communicating and act as a liaison between clinical and billing departments; Stay up to date on current laws determining changes in the law and changes with health insurance companies with regards to medical claims, diagnosis and billing codes required, which can be accomplished by attending all training required by the manager.
Administrative Functions: Types various documents including memoranda, letters, reports, forms, and mailing labels, and stores records in accordance with the State of Texas records retention statute, HHSC standards and HIPAA regulations.
Billing Functions: activities include reviewing health care claims submissions, reconciling paid and unpaid claims, identifying errors, researching health care information using various tools such as state websites, providing a quality review of the claims and communicating with payers to resolve pending issues or denials when instructed by management; Download the submission files, response files, ERAs, R&S, MEVAS pages, from various websites used for billing to include TMHP, our clearing house, SASO, etc.; Use TMHP website, SASO and the clearing house site for researching rejections/recoupments and for determining eligibility; Utilize in-house client software for running case recording detail reports for research and claim recording; Will also review, analyze, document, run reports for all claims and use tracking tools within a specified amount of time; Claim uploads, submissions and write offs with the paid verses unpaid claims count; Update manager on progress and final status of claims invoiced, or write offs, and payment and weekly denials; Communicates with our clients, the IDD program staff, and our oversight agencies when directed and approved by the manager; Perform other job related duties as assigned.
Desired Degree/Job Experience: Associates’s degree in finance, accounting, technical, healthcare, business or related field; A minimum of two (2) years experience with medical billing specifically Medicaid and Medicare billing or medical claims processing, and two (2) years general ledger accounting experience; Prefer five (5) years experience with healthcare background in medical claims processing within government program; or any equivalent combination of experience and training which provides the required knowledge, skill and abilities, including proficiency in Microsoft Excel.
This position is a Pay Grade 10 with a starting hourly rate of $18.77. This is a non-exempt position.Open until Filled. Only electronic online applications will be accepted.
AACOG offers a generous benefits package. These benefits can be reviewed at https://aacog.com/sites/default/files/2022-11/ADVANTAGES%20of%20WORKING%20for%20AACOG%202023_2.pdf
Job Type: Part-time
Pay: From $18.77 per hour
Benefits:
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Tuition reimbursement
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Ability to commute/relocate:
- San Antonio, TX 78217: Reliably commute or planning to relocate before starting work (Preferred)
Work Location: One location