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Cerner Billing Specialist
Ref No.: 18-25778
Location: Prestonsburg, Kentucky
Position Summary:
This role is responsible for the accurate and timely submission of both inpatient and outpatient claims, as well as maintaining all records and reports on those claims.
Education:
High School diploma or equivalent required. Education in business or healthcare beyond high school desirable
Training or Experience:
Experience in a general medical setting desirable. Two years' experience in a healthcare billing / collection environment
Worker Traits:
Ability to communicate in English, both orally and written. Ability to work independently within general guidelines.
Ability to work well with others in a calm, friendly manner in a high volume, high stress environment.

Accountability:
The individual is accountable for the performance of services within the department as described in his/her job description.

Professionalism:
The individual demonstrates commitment and personal growth in his/ her role by demonstrating the philosophies and standards of his / her profession, department and goals of Highlands Regional Medical Center.

Communication:
The individual maintains, supports and/or facilitates communication to assure a constructive working environment as it affects departmental conditions which support the philosophies, goals and objectives of Highlands Regional Medical Center.

Safety:
The individual takes appropriate action to maintain a safe environment for patients, visitors and employees.

Skills:
The individual demonstrates appropriate skills required to meet standards of all criteria for the position held, established and accepted by the department , profession and Highlands Regional Medical Center.

Service:
The individual demonstrates the principles and standards of excellence as accepted by Highlands Regional Medical Center for the promotion of patient and visitor satisfaction and optimal guest relations.



MAJOR TASKS, DUTIES AND RESPONSIBILITIES

The following criteria identify duties to describe the principal functions of the job. Other duties may be required as directed by the Supervisor.
Criteria to
Be Measured


Accountability
  1. Submits all insurance (electronic or paper)claims to third party payors daily. All claims will be submitted on the same day they are received.
  1. Reviews and makes all necessary corrections to claims to ensure that claims are submitted accurately.
  1. Forwards all claims to the appropriate claims representative for additional information when necessary.
  1. Assures proper documentation of all account activity on the patient account in the AS400 /HBOC System. Comments on the status of accounts.
  1. Reviews unbilled charts at least bi-weekly and immediately takes necessary action to prepare account for billing.
  1. Submits billings for physicals, drug testing, etc. to private companies as necessary.


Professionalism
  1. Maintains a clean, orderly work area.
  1. Attends educational and professional meetings and seminars as requested.
  1. Always strives to present a professional image to peers and outside organizations. Maintains composure in a stressful situation and presents a professional appearance in accordance with departmental and hospital dress code.
  1. Reports to work as scheduled and in a timely manner.
  1. Keeps current in skills necessary for satisfactory job performance. Sets high goals and standards for self. Wants to do a better job than is expected.
  2. Keeps an open mind. Is open to new or other ways of doing things. Willing to adopt new ideas.
  1. Maintains strict confidentiality in matters relating to patients' records, hospital matters (both personnel and business) and security codes.
  1. Willing to work when needed.

Communication
  1. Answers telephone inquiries from patients, third party payors and others.
  1. Promptly communicates issues, concerns, and problems to the Claims Supervisor or Department Manager.
  1. Listens. Responds in a way that shows others he/she understands their concerns or issues and offers support or solutions.

Safety
  1. Assists in care and maintenance of equipment and work area.
  1. Attend required JCAHO in-services annually.
  1. Attends and completes all necessary annual safety in-services.
  1. Reports emergencies / faulty equipment to the Claims Supervisor, Department Manager or other appropriate person.

Skills

1. Ability to communicate in English, both orally and in writing.

2. Ability to work independently within general guidelines.

3. Ability to work under periods of stress.

Service

  1. Maintains established department/hospital policies, procedures, objectives, quality assurance, safety, environmental and infection control.
  1. Creates and maintains an atmosphere of warmth, personal interest and positive emphasis as well as a calm environment throughout the department.
  1. Takes actions to make things better for the customer. Attempts to find ways of doing something extra for the customer that will make things easier for him/her.
  1. Adequately documents and reports all issues/concerns involving customer service to the Claims Supervisor or Department Manager.
  1. Assists claims representatives with other duties needed.
  1. Interacts and corresponds with other departments, employees and supervisory personnel in a professional and courteous manner.


Age-Specific Criteria

The Following evaluation is to be used to evaluate staff members on Human Growth and Development of age appropriate patients.

0-1 Neonatal
1-10 Pediatric
10-18 Adolescent
18-65 Adult
65 + Geriatric

1. Communicates appropriately with each applicable age groups using appropriate level of spoken language, visual aids, tone, and courtesy with neonatal, pediatric, adolescent, adult, and geriatric.

2. Demonstrates understanding of age specific expectations for the patient's skin; tissue integrity, mobility, strength, endurance, visual acuity, auditory acuity, and typical diagnosis of patients to age specific categories.