Steward Health Care is the largest private, tax-paying physician-led health care network in the United States. Headquartered in Dallas, Texas, Steward operates 35 hospitals in the United States and the country of Malta that regularly receive top awards for quality and safety. The company employs approximately 42,000 health care professionals. The Steward network includes multiple urgent care centers and skilled nursing facilities, substantial behavioral health services, over 7,900 beds under management, and approximately 2.2 million full risk covered lives through the company's managed care and health insurance services.
Steward Medical Group (SMG), Inc. is Steward's multi-specialty group practice with over 4,500 employees including over 1,800 physicians and advanced practitioners. SMG operates approximately 450 practice locations throughout Massachusetts, Southern New Hampshire, Rhode Island, Pennsylvania, Ohio, Florida, Utah, Arizona, Texas, Louisiana and Arkansas, and provides more than 4 million patient encounters per year.
To function as a member of the administrative team and complete all daily tasks to ensure smooth day to day operations in busy practice. Responsible for posting, coding, and collection of receivables.
- Receives and organizes hospital census, charge sheets and other billing data to be coded and entered into the proper spreadsheet or EPM.
- Contacts various parties to request and/or obtain missing documentation and appropriate coding.
- Reviews and ensures that correct information/ documentation has been entered into the EPM, EMR and hospital, to be able to code the charges correctly before they are billed.
- Organizes, compiles and enters all assigned charges and/or payments, balances to the system, maintains spreadsheets and logs as applicable.
- Reviews all daily charges from the “interface” and corrects errors to ensure proper billing.
- Enters patient demographic information and charges into EPM. Files hard copy based on visit and information entered.
- Provides coding feedback to the medical providers regarding billing problems via e-mail.
- Attains proper documentation from the patient’s medical record and assures that all new or denied claims are corrected utilizing CPT-4 and ICD-9 codes to insure proper reimbursement.
- Reviews, copies and appeals denials as outlined in the Explanation of Benefits.
- Audits patient accounts and generates claims for billing secondary claims.
- Audits patient accounts to ensure that refunds and adjustments are properly done.
- Handles the “CBO front desk” collections and patients with billing inquires.
- Research and contact various parties to obtain information to submit corrected data for re-billing. Such as researching addresses from returned mail, contacting the patient for correct billing information, calling hospitals and other agencies for proper documentation, etc.
- Timely communicates, verbal or written, with payers to expedite collections.
- Handles “Billing Phone” for all patient billing questions in a timely manner.
- Contacts patient to inform them of coverage of services and their responsibility prior to appointment date. (diabetes management, etc)
- Call insurance companies to verify insurance eligibility and coverage. Requests appropriate referrals when required by the insurance companies.
- Follows Universal Precaution Procedures while performing applicable duties.
- Complies with the facility privacy policies and procedures for the management of protected health information (PHI)
- Understands that ignoring situations where PHI may have been potentially compromised comes with legal ramifications to both the practice and myself.
- Utilizes appropriate Personal Protective Equipment in the performance of duties.
- Demonstrates knowledge of policies and procedures applicable to job position.
- Maintains computer skills, keeps up with coding and billing updates necessary to insure accuracy and efficiency in the performance of all assigned job duties.
- Adheres to infection control and safety policies, including education, reporting and practice implementation specific to job position.
- Helps to maintain the office area to reduce the risk of safety hazards and enhance general appearance.
- Protects and honors patient and co-worker confidentiality.
- Consistently adheres to Agency dress code.
- Work independently or as a “Team” and without direct supervision by prioritizing work and following through on duties.
- Meets attendance and punctuality expectations.
- Behavior toward coworkers, supervisors and patients consistently displays a courteous respectful attitude and promotes teamwork within the organization.
- Performs other duties as assigned by supervisor.
• Education from approved medical administrative program or equivalent
• High School Diploma or equivalent
• 1 to 3 years of experience as a Clinical Secretary/ Billing Specialist
• Experience with electronic medical record strongly preferred (Athena a plus)
• Experience with Microsoft Office, Word, Excel and Outlook