Job Descriptions

 

Medical Biller

Under the general supervision of supervisor, the Medical Biller is responsible for timely submission of claims to insurance companies, as well as monitoring and ensuring payments for services are received in a timely manner. Medical Biller may also function as an intermediary between healthcare provider, patients and health insurance companies.

DUTIES AND RESPONSIBILITIES:

• Reviews charges for accuracy and completeness, obtains any missing information.
• Knowledge of insurance including HMO/PPO, Medicare, Medi-Cal, rules and guidelines.
• Identify insurance company or proper party (patient) to be billed; identify and bill secondary or tertiary insurances.
• Reviews EOBs and Remittance Advises for accuracy.
• Calls insurance companies regarding any discrepancy in payment or denials.
• Follows up on unpaid claims to identify those that need to be re billed; or, if no payment activity for six months, reviews with Director of Revenue Cycle for possible bad debt write-off.
• Assists as needed with Month-end close procedures.
• Responsible for keeping up to date with current billing protocols by payer and may be held responsible for expertise in certain areas.
• Handles patient inquiries. Investigates patient concerns regarding their accounts.
• Update patient demographic information.
• Checks eligibility and benefits.
• Attends and participates in staff meetings and training sessions.
• Consult supervisor, team members and appropriate resources to solve billing/collection questions and issues.
• Perform a variety of administrative duties including but not limited to answering phones; faxing and filing of documents.
• Performs other duties as assigned by the Director of Revenue Cycle.

QUALIFICATIONS:

1. Billing Certificate or equivalent experience
2. Knowledge of:

o Medical Terminology

o Medical Claim Billing procedures.

o CPT-4 and ICD-10-CM coding systems.

3. Customer service and effective communication skills for interacting with patients and insurance payers to resolve any issues. (Bilingual preferred)
4. Minimum 1 year experience preferred.

Job Type: Full-time

Medical Assistant

 

REPORTS TO:                  Supervisor /Medical Assistant Lead

RESPONSIBILITIES:

Supports the mission, vision and values of Imperial Beach Community Clinic. Develops relationship, communication, and MA skills with the overall goal of providing excellent patient-centered treatment, care, and services in a team environment.

 

• Works within a team-care environment to provide excellent patient care services within scope of practice as established by the Medical Board of California.
• Participates in staff education and training activities in communication, care coordination, population management and program evaluation, as required.
• Coordinates duties with and from licensed providers, RNs, LVNs, Director of Nursing and Senior Leadership.
• Participates in pre-visit planning through team huddles
• Creates opportunities for patient access
• Communicates effectively with care team throughout the day
• Maintains efficient patient care flow throughout the day
• Provides continuity of care for the patient within the care team for that day coordinating with other departments as needed i.e. lab/CM/outreach
• Collects and records patient data for vital signs, height, weight, and basic medical history
• Administers medications and vaccines
• Collects specimens and in-house diagnostic tests
• Performs uncomplicated wound care
• Conducts non-invasive treatments (e.g. ear lavage)
• Assists in ambulation and transfers
• Prepares patients for procedures, does set up for procedures and assists provider as delegated
• Provides patient instructions and education upon authorization of the provider
• Performs emergency first aid and CPR when delegated
• Records results of treatment and responses to care in the medical record, consistent with IBCC protocols in general documenting
• Participates in staff education and training activities in CPR/ IBCC requirements. Maintains required competencies as established
• Assists in facility management including keeping patient areas clean and safe
• Assists in responding to and resolving patient complaints as needed.
• Proactively assumes responsibility for continuous improvement activities and is receptive to accepting other job duties as assigned and as delegated.
• Conducts audio and vision screenings
• Performs collateral duties such as maintenance logs, vaccine temps, oxygen, glucometer
• L.A.D.D. internal and external customer service
• Professional conduct, attire and appearance
• Checking EHR frequently for messages from providers and contacting patients regarding results over the phone
• Helping out other MAs when they are busy (part of team environment). Being proactive rather than reactive.

KNOWLEDGE OF: Basic MA procedures and medical terminology.

SKILLS: Basic computer and data entry skills; excellent communication and customer service skills.

ABILITY TO: Handle multiple priorities, build positive relationships, maintain a positive attitude and a warm and friendly demeanor; efficiently work in a team environment; travel as required for assigned site(s) and designated meetings/trainings. Lift and/or move up to 40 pounds and push 100 pounds on wheels. Specific vision abilities include close vision and the ability to adjust focus; high manual dexterity; reach above shoulder level; bend; squat; sit; stand; stoop; crouch; reach; kneel; twist/turn; have good finger sensation; hearing adequate for phone work; and clear speech for staff and patient communication.

• Adheres to the IBCC Mission, Vision, and Values, Standards of Conduct and HIPPA principles
• Consistently adheres to and/or exceeds IBCC’s communication guidelines and expectations with
  patients, peers, and supervisors. Greets every patient with a verbal greeting, eye contact and a smile. Communicates effectively by using welcoming words, proper tone of voice appropriate body language, eye contact and smiling in patient interactions. Listens skillfully and displays a willingness and ability to acknowledge patient needs, expectations and values through the use of reflective listening and empathy conveyance. Responds to patient needs in ways that are helpful and beyond expectation.
• Collaboratively works with patients to positively affect their health outcomes.
• Builds positive relationships with other staff to maximize accessibility of care to all patients.
• Participates in continuous quality improvement activities and patient-centered medical home team meetings and trainings, and is receptive to accepting other job duties as assigned and as delegated

Knowledge: Customer service,

Ability to: Work well with people; communicate effectively and respectfully in English and/or other languages;