Guthrie

Position Summary: Responsible for preparing insurance billings pertaining to patient accounts; coordinates activities with all primaries, including RMSCO, Blue Cross/Blue Shield, Commercial, Compensation/No Fault, Medicaid and Medicare and all other insurance plan, and follow up with insurance companies to ensure timely payment.. Notifies department manager of all issues that result in denial or delay in claims processing and works with manager to correct issues.. The Guthrie Clinic is a non-profit, integrated, practicing physician-led organization in the Twin Tiers of New York and Pennsylvania.. Guthrie Medical Education Programs include General Surgery, Internal Medicine, Emergency Medicine, Family Medicine, Anesthesiology and Orthopedic Surgery Residency, as well as Cardiovascular, Gastroenterology and Pulmonary Critical Care Fellowship programs.. Guthrie is also a clinical campus for the Geisinger Commonwealth School of Medicine.

administration

Job Description Position Summary: Responsible for preparing insurance billings pertaining to patient accounts; coordinates activities with all primaries, including RMSCO, Blue Cross/Blue Shield, Commercial, Compensation/No Fault, Medicaid and Medicare and all other insurance plan, and follow up with insurance companies to ensure timely payment. Experience: Knowledge of business and office machines, excel and word. Knowledge of insurance plans and coverage‘s. Complete understanding of ICD‐9 and CPT coding as it relates to billing. Proficient in typing and keyboarding skills. 50‐60 WPM. Ability to calculate percentages. Ability to comprehend insurance explanation of benefits. Knowledge of accounting practices (debit/credit transfers). Able to perform independently while interacting with wide cross section of community to include patients, physician offices, and insurance companies. Ability to perform multiple tasks in a very busy environment. IDX experience mandatory. Ability to communicate/interact with wide cross‐section of individuals in a courteous/tactful manner. Understanding of patient needs/rights. Discretion with regard to safeguarding confidential information. Must possess an abiding commitment to basic ethical and legal principles. Essential Functions: Receives patient bills from Data Processing & prepares billings in a timely manner. Works closely with other departments in coordinating interdepartmental functions related to the billing of all insured patient accounts. Reviews insurance explanation of benefits to insure accuracy of bill and makes all necessary corrections. Prepares charge off and transfers according to established procedures. Helps in the mailing of statements when necessary. Responsible for coverage at the cashier window when scheduled by the Assistant Director of Patient Accounts. Corrects all edits within the NDC health system daily. Notifies department manager of all issues that result in denial or delay in claims processing and works with manager to correct issues. Performs other duties as assigned. Mails all insurance billings to the proper carriers on secondary and primary. Codes all necessary claims using proper ICD‐9 codes. Codes all appropriate billings with proper CPT codes. Follows up all billings to insurance on a timely basis, per department procedures by use of aged trial balance and targeted trial balance reports. Enters all pertinent information on the CRT concerning patients account, i.e., billing date, follow up date, patient conversations, transfer to self‐pay, updates, addresses and insurance information as to co‐pay deductibles, etc. Answers patient and insurance company correspondence daily. Calculates NYS surcharge when necessary and verifies that calculated surcharge is correct. Must be aware of all changes pertaining to laws governing insurance billings. Other Duties: Demonstrates age specific competencies as per department standards. Maintains good inter and intradepartmental relationships, interacts effectively with all customers both internal and external Strives to conduct self in manner that positively reflects on organization. Maintains current knowledge of and adheres to all departmental and organizational policies and procedures. Demonstrates clinical and technical competencies as per department standards. Utilizes time to department’s best advantage and in a manner to achieve high quality work and services and maximize productivity and efficiency. Exhibits initiative in performing all duties, regularly assists co‐workers, consistently strives to be a productive member of the department and the organization. Consistently demonstrates good judgment, ability to assess situations, consider alternatives, and select appropriate course of action. Consults supervisor as appropriate. Fully supports and utilizes the organization’s Continuous Quality Improvement process ‐ participates in activities as established and agreed to identifying problems and working toward resolution. Maintains desired attendance level, arrives on time at start of scheduled shift and returns promptly after breaks and lunch periods. Attends annual update and review educational session Complies with requirement for annual physical assessment within appropriate timeframe. The pay for this position ranges from $16.00-$22.37 per hour. About Us Joining the Guthrie team allows you to become a part of a tradition of excellence in health care. In all areas and at all levels of Guthrie, you’ll find staff members who have committed themselves to serving the community. The Guthrie Clinic is an Equal Opportunity Employer that welcomes and encourages diversity in the workplace. The Guthrie Clinic is a non-profit, integrated, practicing physician-led organization in the Twin Tiers of New York and Pennsylvania. Our multi-specialty group practice of more than 500 physicians and 302 advanced practice providers offers 47 specialties through a regional office network providing primary and specialty care in 22 communities. Guthrie Medical Education Programs include General Surgery, Internal Medicine, Emergency Medicine, Family Medicine, Anesthesiology and Orthopedic Surgery Residency, as well as Cardiovascular, Gastroenterology and Pulmonary Critical Care Fellowship programs. Guthrie is also a clinical campus for the Geisinger Commonwealth School of Medicine.

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