About Our Family:
Established in 1978, Alcona Health Center (AHC) is a non-profit, Federally Qualified Health Center dedicated to making a lasting impact in the Northern MI communities we serve, offering medical, behavioral health, dental and pharmacy services. As a member of the AHC family, you will join a team of over 300 coworkers, all devoted to providing quality health care to all residents of our communities, regardless of their ability to pay.
Your Valued Contributions:
Successfully bill patient accounts to the appropriate insurance company for payment, reconcile insurance payments and denials, follow up with insurance companies as needed, receive and resolve patient and insurance company phone calls regarding patient accounts. Interrelates with providers, insurance companies, other health care organizations, the public and the staff. Acts as a primary resource for department staff while working closely with the Revenue Cycle Manager.
- Processes claims, both electronic and hard copy timely and accurately, ensuring a timely turnaround of accounts receivable. Maintains proficiency on health center’s electronic billing system. Monitors claims for missing information and authorization numbers. Notifies Billing Supervisor if any billing issues are found.
- Responsible for responding to all inquiries, billing denials, other correspondence and phone requests in an efficient , timely, and effective manner. Secures needed medical documentation required or requested by insurances.
- Interacts with patients in order to provide assistance to resolve billing issues. Consistently demonstrates a positive attitude. Fosters teamwork by offering assistance to others. Acknowledges and responds tactfully to all requests. Shows consideration in interaction with patients, family, and other healthcare team members by demonstrating listening skills and cooperation. Communicates and interacts with others in a professional, responsible, cooperative, and positive manner at all times. Adheres to Health Center policies & procedures.
- Completes work within authorized time to assure compliance with departmental standards. Utilizes monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days.
- Keeps updated on all billing requirements and changes for all insurance types.
- Works with Health Information Department staff to ensure that complete diagnosis/procedure codes and modifiers are reported to insurance carriers as required.
- Screens medical records for completeness of documentation. Interacts and follows up with healthcare providers and staff on all communications related to coding.
- Follows up with insurance carriers timely on unpaid claims until claims are paid or only self-pay balance remains. Does not have claims written off for timely filing.
- Processes rejections daily by either making accounts self-pay and generating a letter of rejection to patient or correct any billing error and resubmitting claims to insurance carriers.
- Effectively and efficiently trains all new staff in accordance with current processes, procedures, and best practices while appropriately documenting the training process.
- Acts as a knowledgeable resource for Billing Department staff questions.
- Acts as a knowledgeable resource for Site Manager and site staff questions.
- Provides as needed coverage for staffing gaps.
- Takes the initiative to be the first person to move to areas in billing with a greater need such as assisting with large postings, insurance reprocessing issues, etc.
- Identify system issues with billing and report to manager, making recommendations for solutions when applicable.
- Consistently documents all conversations with payers and customers in patient accounts.
- Maintains confidentiality of protected health information at all times.
- Secures needed medical documentation required or requested by insurances and sends in a timely manner.
- Follow current COVID-19 guidance from applicable agencies as it pertains to the role.
- Exercise discretion and strict confidentiality with all information including but not limited to sensitive personal information, and medical information.
- Consistently adheres to organization rules, regulations, and policies, including but not limited to the AHC Code of Conduct and Compliance policies.
- Attendance
- Ensures attendance and hours worked are accurately recorded.
- Properly manages paid vacation and sick leave.
- Responsible for regular, predictable attendance and to work hours as scheduled.
- Accepts and performs other job-related duties, projects, and responsibilities, as required.
Required Training & Experience:
- Possesses the ability to secure transportation to allow for reliable and timely work attendance, including when business is required to be conducted at sites other than your primary worksite.
- Word & Excel
- Electronic Health Records system
We’re Here For You:
Supporting Balance: As a part of our family, you will work full time (40 hours/week), in our Lincoln location with a starting wage dependent on education and experience. Numerous holidays, generous vacation time and sick days are also offered.
Supporting Your Health: Low deductible Medical, Rx, Vision & Dental insurance at a minimal cost for employees.
Supporting Your Future: Retirement Savings Plan, FSA, Life, AD&D, & Short/Long Term Disability Insurance.
Supporting Your Education: Continuing Education Assistance program. Employment with AHC may also qualify you for student loan forgiveness under the Public Service Loan Forgiveness program.
