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Entry Level -Accounting Insurance Associate (Evening/Weekend)

The Accounting Insurance Associate (AIA) is responsible for performing routine balancing, billing and editing functions and provides after-hours insurance, clerical and administrative support to patients, clinics and billing office.  Based on business requirements the AIA will be expected to occasionally perform other duties within the billing office as assigned by Supervisor.

Work Hours:

The work schedule is a 35/40 hour full-time rotating schedule. Rotations will be assigned to include five shifts per week from the following: 1) Monday through Friday from 1 p.m. to 9 p.m.; 2) Monday through Wednesday from 1 p.m. to 9 p.m. and Saturday/Sunday from 1 p.m. to 9 p.m.; 3) Monday/Thursday/Friday from 1 p.m. to 9 p.m. and Saturday/Sunday from 9:00 a.m. to 5:00 p.m. Occasional overtime or variations may be required or authorized.

Education & Training:

  • Must have High School diploma or GED
  • Must have one of the following:
    • 1 Year related experience
    • Certificate in related field plus 6 months work experience

Essential Knowledge, Skills & Abilities:

  • Must be organized, detail-oriented and able to adapt quickly to stressful work environment
  • Must have excellent customer service and interpersonal skills with patients, clients and staff
  • Must be able to work in team environment, as well as independently
  • Must be able to read, correctly interpret and follow written guidelines/protocols
  • Must be able to learn and apply new skills
  • Must be able to communicate effectively in English (grammar, spelling, writing, and verbal skills)
  • Must possess effective reasoning and deductive ability
  • Must have basic computer and keyboarding skills: Microsoft Word required, Excel and Outlook preferred
  • Must maintain confidentiality when dealing with medical information
  • Experience using a 10-key adding machine preferred
  • Basic knowledge of private and/or managed care insurance preferred
  • Basic knowledge of CPT and ICD-9 codes preferred
  • Knowledge of medical terminology, its spelling and abbreviations preferred
  • Medical software experience preferred
  • Medical transcription experience helpful
  • Ability to communicate in Spanish helpful

Position Advancement:

The AIA has the opportunity for advancement to the AIA II position after meeting the following requirements:

  1. After being in the AIA position for 2 years:
    • Must score at least 3.40 on annual date-in-position evaluation for last 2 years
    • Must not have a Performance Improvement Plan (PIP) in last 12 months
    • Must have a good time and attendance record with no suspensions in last 12 months
    • Must not have written disciplinary action in personnel file in last 12 months
    • Must have Evening Accounting/Insurance Manager (EAIM) or EAISS recommendation for promotion

Essential Job Functions & Duties:

Clerical Duties
  1. Processes incoming mail on assigned dates
    1. Opens all receivable mail
    2. Makes sure each check has supporting documentation (even if it is a copy of the check)
    3. Separates Explanation of Benefits (EOBs) and checks
    4. Circles dollar amount of check and check number on EOBs in red ink (write in check number if necessary)
    5. Balances deposit by using provided Excel spreadsheet for EOBs and checks
Billing Duties
  1. Clinic and patient support
    1. Explains or clarifies billing procedures to clinic staff and patients
    2. Locates and faxes requested information to clinics
    3. Provides phone support to clinics by determining if patient’s insurance will be accepted
    4. Obtains insurance coverage verification, if needed and resources are available
    5. Researches delinquent accounts to determine validity of balance when requested by clinic
    6. Processes patient credit card payments over the telephone as needed
    7. Prepares recurring patient credit card payments for day staff to process
  2. Evening Billing Reports
    1. Edits all demographic and insurance information and make corrections as needed to include updating the Doctor’s Master spreadsheet
    2. Reviews and corrects insurance ID formatting
    3. Reviews and corrects missing group numbers
    4. Reviews and corrects MD –Search for correct Diagnosis/ICD codes
    5. Reviews and corrects patient age to make sure minors are not listed as guarantor
    6. Reviews and corrects Medicare formatting as needed
    7. Reviews and corrects Medicare initial visits to follow-up visits including moving payments
    8. Reviews and corrects all Manual Voids
    9. Reviews and corrects 88888 and 99999 codes for correct fees
    10. Reviews and corrects Centricity Charge report and corrects charge and payment codes as needed
    11. Corrects fee if not equal to zero
    12. Reviews and corrects Contractual Analysis report for rabies rendering provider
    13. Reviews and corrects IV Infusion report for IV bag CPT codes
    14. Reviews and corrects Swift CT scan for rendering provider
    15. Reviews and corrects Dr. Swift OV for rendering provider
    16. Reviews and corrects any additional reports as assigned by supervisor
    17. Scans TransFirst credit card report into the appropriate clinic folder
  3. Reviews, corrects and balances End of Day (EOD) reports/books
    1. Runs Daily Balance Charges report in NextGen for previous day’s visits
    2. Ensures that charges balance with the Doctor’s Master spreadsheet
    3. Makes the appropriate corrections to bring these two items in balance when needed
    4. Ensures that the total gross revenue from the Daily Balance Charges report and the Doctor’s Master spreadsheet are in balance and make appropriate corrections to balance
    5. Ensures actual cash, checks, credit cards and receivables match the Doctor’s Master spreadsheet and Batch Listing Reports by comparing deposit slips and TransFirst Transaction Summary Report. When necessary, reconcile any differences
  4. Reviews all receivable payments per clinic/day
    1. Corrects NextGen bad debt credit card transactions by adding transactions with correct payment codes in clinic batch and reversing existing transactions
    2. Drills down into the patient’s encounter via the Batch Listing report
    3. Notates if the encounter is listed as an Internal, SARMA or Account Services collection account
    4. Notates the line item details of the patient’s receivable payment
    5. If there is a payment amount (or several) and a service charge that are entered into individual line items
  5. New Transactions
    1. Creates a transaction and enters all line items except the service charge with the correct payment code
    2. Creates a second transaction and enters the service charge with the correct payment code
    3. Creates a third transaction to reverse the original payment the clinic entered
    4. Corrects NextGen bad debt cash and check transactions by editing and/or adding transactions with correct payment codes in clinic batch and deleting transactions you have replaced
    5. Follows the process listed in the previous step except for the reverse original payment transaction screen
      1. Creates a transaction and enters all line items except the service charge with the correct payment code
      2. Creates a second transaction and enters the service charge with the correct payment code
      3. Deletes the original transaction that the clinic staff entered
    6. Uses the daily TransFirst Transaction Summary report and the Batch Listing report for each clinic to add all “Other Clinic” credit card receivables in the “Other Clinics” receivable master spreadsheet
    7. Corrects patient accounts/encounters in NextGen and Doctor’s Masters Spreadsheet using the QC reminder corrections for charges, diagnosis, etc. provided by the Clinic Manager (CM)
    8. Ensures that any missing money is reported by CM by creating and providing to the CM an Incident Report for any shortages
    9. Sends an additional Incident Report to the HR Director (HRD) for investigation of any missing money over $50
    10. Copies should be forwarded to the CM and direct supervisor
    11. Re-checks accuracy of patient information, charges and payments by re-running clinic reports to screen
    12. Makes necessary corrections on checkouts, and in the computer
    13. Prints final reports that include all changes and corrections
    14. Completes the EOD spreadsheet ensuring that all totals balance with the Daily Balance Charge Report, Batch Listing, Doctor’s Master spreadsheet, deposit slips and TransFirst reports
    15. Moves EOD documents to a PDF file in the Accounting folder (located in the Medical Records folder)
    16. Runs original Manual Void report when assigned by supervisor
    17. Gives needed corrections to the staff member that originally completed the books
    18. Runs initial billing for Managed Care when assigned by supervisor
    19. Keeps Managed Care informed on a daily basis of what billing has been completed and what is ready for them to process corrections
    20. Files charts
  6. Collection Responsibilities
    1. Will work on a tasking prelist to call patients for outstanding balances
    2. Will set up payment plan
    3. Will process a payment
    4. Documents activity in billing system with a note
    5. Completes task in billing system
    6. Documents number of calls and payments made
  7. Work must be completed within assigned deadlines
  8. Miscellaneous
    1. Alerts day staff regarding patient/clinic issues that need to be resolved the next business day
    2. Assists supervisor in training other staff members

Other Duties:

  1. Interacts with staff members professionally
  2. Follows company policies and procedures (time and attendance, appropriate attire, etc)
  3. Correctly uses office equipment
  4. Works safely
  5. Must be punctual and reliable in attendance
  6. Other duties as assigned

Customer Service Skills:

  1. Meets the service expectations of patients
  2. Resolves problems identified by patients
  3. Meets the service expectations of internal customers
  4. Resolves problems identified by internal customers
  5. Follows through on commitments
  6. Interacts with co-workers in other departments in a manner that promotes teamwork and facilitates company goals

Working Conditions & Risks:

Work is indoors in a well lighted, and seasonally heated and cooled business office.  Job hazards are estimated to be minimal (low risk).  Potential risk exists from accidents while using routine office equipment.

Physical Requirements:

Position requires occasional need to lift heavy (30-50lbs) boxes from floor to chest height.  Prolonged sitting, sorting, moving about, and intermittent typing approximately 4-7 hours per day routinely.  Good vision, good hearing, and clear speech required (correctable).  Repetitive motions consist of extended periods of upper body and upper limb movements (arms, hands, and wrists).

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