Medical Administrative Assistant

Description

This position is internally known as a Medical Billing Assistant. The billing assistant provides support to the USPI billing & collections department in an effort to expedite case management. The billing assistant’s primary responsibility is to mail clean claims in a timely manner with appropriate documentation to the responsible payor. They will oversee around 30-35 surgical centers with an average monthly volume of 10-15k cases.

Responsibilities:

• Review Clearinghouse EDI Payer ID's and EMR system to see if claim can be sent electronically vs paper.
• Print all paper claims from Vision/AdvantX, review claims for accuracy including modifiers, payers, claims addresses, and additional pertinent information included.
• Ensure overall claim alignment and claim formatting per payer guidelines.
• Gather all supporting documentation such as operative notes, block reports, implant logs, etc. which MUST be attached with mailed claims.
• Scan and upload claims & supporting documentation to daily work folder and/or claims management system.
• Notate in the EMR system with date claim was sent, mailing address, and supporting documentation mailed with claim.
• Manage claim queues to ensure that cases are assigned to the correct team member for processing.
• Collaborate as a team to mail overpayment letters and review returned mail twice a week.
• Monitor communication and automation between various systems to ensure documents are getting to the coding team in a timely manner.
• Coordinate with the billing team to update corrections that need to be addressed in greater detail are completed.
• Complete additional duties as assigned.

Requirements

• High School diploma or equivalent
• 1-2 years’ experience in medical billing and/or accounts receivable is preferred, but not required
• Knowledge of CPT & ICD-10 codes
• Strong attention to detail.
• Ability to complete independent assignments with minimal supervision.
• Basic knowledge of payers, EOB’s and claims processing 
• Basic knowledge of billing software, vendors, and clearinghouses