HEALTH INFO SPECIALIST I/II - PART TIME
Position Number: S-3748
Position Summary:
Process insurance and patient payments and posts into patient accounts in the EMR . Performs reconciliation processes daily. Ensures the quality of medical records through chart audits and confirms and/or assigns appropriate coding and billing elements according to regulations, guidelines and rules. Performs credentialing/enrollment activities. Provides support to the health information system operation. Prepares statistical reports and studies. Maintains the confidentiality, security and organization of medical records. Releases patient information while following all internal processes. Follows all HIPPA and FERPPA standards as they relate to all duties.
Required Qualifications:
(ST-5) HEALTH INFORMATION SPECIALIST I:
High School Diploma or GED .
Two years demonstrated experience in electronic medical billing and/or coding, and/or payment posting.
Extensive knowledge in ICD -10-CM, CPT , and HCPS coding system.
Experience in electronic filing of health insurance claims.
Experience with answering billing/coding questions.
Excellent critical thinking and problem-solving abilities.
Able to function effectively as a member of a multi-disciplinary team Demonstrated positive interpersonal skills.
Demonstrated ability to communicate effectively in a professional manner and project a positive attitude.
Ability to perform the essential functions of the job with or without reasonable accommodation.
(ST-6) HEALTH INFORMATION SPECIALIST II: ADDITIONAL QUALIFICATIONS
Five years demonstrated experience in electronic medical billing and/or coding, and/or payment posting.
Extensive knowledge in interpreting EOBs, payment vouchers.
Demonstrated ability to resolve complex billing and insurance issues.
Demonstrated ability to interpret patient accounts and monitor patient billing cycles.
Demonstrated ability to communicate and/or train other staff in insurance guidelines and monitoring of patient accounts.
Demonstrates strong leadership characteristics and initiatives that closely align the Central Michigan University Leadership Standards.
Preferred Qualifications:
(ST-5) HEALTH INFORMATION SPECIALIST I:
Knowledge and experience in use of Epic.
Knowledge of university policies and procedures.
Knowledge of medical terminology
(ST-6) HEALTH INFORMATION SPECIALIST II:
Associate’s degree preferably in health information management or equivalent education and experience and/or Certification as a Coding or Billing Specialist or eligible for certification.
Experience in Provider credentialing and enrollment.
Experience in accounts receivable and collections.
Duties & Responsibilities:
(ST-5) HEALTH INFORMATION SPECIALIST I:
Performs medical record audits (based on HCFA and AMA regulations and guidelines).
Review, interpretation and coding of services provided.
Solves coding, billing, and insurance issues.
Payment posting including interpretation of EOBs, vouchers.
Reconciles patient accounts and answer patient questions regarding their account.
Monitors aging accounts and work according to department standards.
Assists with internal collection processes related to patient accounts.
Assists with provider credentialing and enrollment as needed.
Retrieves and delivers medical records as requested by patients, outside providers, insurance carriers, lawyers, etc
Coordinates outgoing referrals from providers: email referral packet to patient, contact specialist to set up appointment, send all pertinent records to specialist office.
Attends seminars, takes part in webinars, looks for other educational opportunities in order to stay up to date regarding government, AMA , and insurance rules related to documentation guidelines for auditing and coding purposes.
Prepares statistical reports and studies.
Provides support to health information systems operations.
Performs other duties as assigned.
(ST-6) HEALTH INFORMATION SPECIALIST II:
Performs credentialing and enrollment functions; ensure new providers are credentialed with payers, as well as maintaining credentialing on current providers.
Manages coordination of care and billing between CMU Health and affiliated offices both on and off campus.
Manages all aspects of CMU Health internal collections efforts, including coordination with CMU student accounting and external collection agency.
Communicates knowledge and findings with CMU Health staff including Providers to include training of others.
Leads process improvement efforts and initiatives as it relates to health insurance claims, patient accounts, medical billing and coding, provider credentialing and enrollment and healthcare compliance to include research, implementation and training as needed.
Uses independence of action and judgement to investigate and resolve complex insurance claim, billing and payment discrepancies, provides follow-up on claim denials and files appeals when appropriate.
Responsible for ensuring compliance of medical, governmental and university policies and procedures as it relates to the duties performed in this position.
Assists with the process for supervising physician agreements and renewals
Reviews and ensures resolutions for Monthly Aged Accounts
Performs billing duties, utilizing specific knowledge of medical terminology and hospital and office procedures.
Processes selected billings and payments
Performs other duties as assigned.
Supervision Exercised:
None.
Employee Group: Supervisory Technical
Staff Pay Level:
Pay Range: ST5: $17.00 - $26.50per hour (estimated $17.00 - $19.00)/ST6: $18.50 - $28.00per hour, (estimated $18.00 - $21.00)
Division: Academic Affairs
Department: University Health Services
Position Status: Regular
Position End Date:
Employment Status: Part-Time
FTE: 0.900
Position Type: 12 month
Weekly Work Schedule: Monday-Friday
Location: Mount Pleasant, MI
Posting Ends:
Open Until Filled: Yes
To view the full job posting & to apply, visit https://apptrkr.com/6665810
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