Patient Billing Representative - Health

at Sedgwick County in Wichita, Kansas, United States

Job Description

The Patient Billing Representative provides billing support for clinical services to support the Sedgwick County Health Department (SCHD) in their mission to prevent disease, promote wellness, and protect the public from health threats. This position provides billing support for clinical services provided to insured and uninsured clients. The Representative performs the day-to-day billing functions of SCHD in accordance with current acceptable accounting and cost reimbursement principles relating to health care and the Sedgwick County Department of Public Services Division. This position is within the Health Department Finance Program and works with staff, clients, and insurance companies regarding billing in Health Department programs such as Immunizations, Family Planning, and Tuberculosis Control. Employee will provide support during public health emergencies (Activation Level 1).

Coding

• Verify accurate CPT codes
• Verify accurate payor on client accounts
• Audit Code compliance that all charges are included on claim
• Act as a liaison between insurance company and medical staff
• Troubleshoot coding issues in the billing system

Billing

• Review claims for accuracy, including demographics and coding.
• Verify the charges, adjustments, and revenue collected.
• Validate that claims go through the process to collect prior to sending the claim to the collection agency.
• Respond to clients regarding billing questions and payments
• Process customer refunds based on information provided by billing company.
• Ensure daily payment information is sent to billing company.
• Research client EOB for accurate a payment allocation
• Provide training to Health Department Customer Service Associates
• Verify the charges, adjustments, and revenue collected.
• Act as the Liaison between Health billing system, IT, Administrative Specialist and Medical staff
• Confirm all claims are being worked in a timely manner within payor established timelines
• Acquire and maintain backup copies of electronic (EOB) details on all accounts.
• Submit claims for Set off prior to the beginning of each year

Financial and Billing Backup

• Reconcile bank deposits to the revenues recorded in SAP
• Keep up to date records with State of Kansas Setoff program, updating information when payments are received.
• Review denied claims and make necessary changes to receive payment. Confirm denied claims are supported by documentation
• Reconcile payments with EOB recorded by billing company with revenues in internal accounts receivable
• Prove removal of all claims from inventory listing are supported by payment, denials, or write-off’s according to policy.
• Audit patient accounts for aging claims

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