(USA-OH-Cincinnati) Gatekeeper (Billing and Documentation)
Department:Billing (Accounts Receivable) Job Title:Billing/Office Support SALARY GRADE:C0700 FLSA STATUS:Non Exempt Effective Date:April 2012 Under the supervision of the Front-End Manager and Operations Manager; the gatekeeper is responsible for accurate and timely preparation of complete patient billing and support documentation for the Billing Department, including appropriate notes into the Zoll System. Responsible for fulfilling all Medicare/Medicaid requests for Medical Necessity and non-emergent runs. Primary Responsibilities and Duties: * Reviews completed bills and all required documentation received from crews for completeness and ensuring all necessary forms are present. * Reconciles bill received report; completes workflows and performs required mailings according to Medicare and Medicaid guidelines. * Forward hard card, run sheet and any other supporting documentation to the billing department. Scans documents as directed. * Forward all information to the Operations Manager and/or supervisor for follow-up regarding bills, substandard documentation and missing forms. * Notifies Operation Manger of any transport not meeting medical necessity. * Meet with crew-members demonstrating a need for additional documentation remediation and record training sessions for employee files as required by leadership. * Notify the billing office of any repetitive transport not meeting medical necessity. * Maintains files in an orderly fashion. * Contact physician offices, medical record clerks etc. as needed to obtain correct patient/transportation information. * Maintain confidentiality of ALL patient, employee and corporate records and information in accordance with all HIPAA and any other governmental/administrative policies/procedures/regulations. * Complete other duties as assigned. * Exhibits excellent customer service skills and behaviors toward internal and external customers and co-workers. * Adheres to department customer service and performance standards. Knowledge Skills and Abilities Required: * Minimum Education: High School Diploma or Equivalent. * Minimum Work Experience: Must have three to six months of work experience and basic knowledge of office procedures. Ability to work well with the public. Excellent customer service skills and the ability to work in a team based environment. * Contact with Others: Works closely with Crews, Front-end supervisor and Operations Manager, as well as various other hospital departments and physician practice offices. * Analytical Demands: Must have the ability to organize work activities to ensure efficient use of time and acceptable productivity. * Certification, Licensure, Registration: None required. Working Conditions: * Physical Effort: Mental, visual stress related to computer input. Viewing of computer screens and printed material for prolonged periods of time. Lifting limited to a box of forms weighing 10-12 pounds. Prolonged periods of sitting. * Work Environment: Normal office environment with limited exposure to health or accident hazards. * Equipment Used: Computer, printer, scanner, telephone, calculator and other assorted office equipment as well as insurance communications systems. Working Relationships: * Reports to Front-End Billing Manager and Operations Manager. The above primary job duties and responsibilities describe the level and nature of work performed by the employees assigned to this job. The description should not be construed as an exhaustive listing of all job duties and responsibilities performed by this job.
(USA-OH-Cincinnati) Gatekeeper (Billing and Documentation)
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Department:Billing (Accounts Receivable) Job Title:Billing/Office Support SALARY GRADE:C0700 FLSA STATUS:Non Exempt Effective Date:April 2012 Under the supervision of the Front-End Manager and Operations Manager; the gatekeeper is responsible for accurate and timely preparation of complete patient billing and support documentation for the Billing Department, including appropriate notes into the Zoll System. Responsible for fulfilling all Medicare/Medicaid requests for Medical Necessity and non-emergent runs. Primary Responsibilities and Duties: * Reviews completed bills and all required documentation received from crews for completeness and ensuring all necessary forms are present. * Reconciles bill received report; completes workflows and performs required mailings according to Medicare and Medicaid guidelines. * Forward hard card, run sheet and any other supporting documentation to the billing department. Scans documents as directed. * Forward all information to the Operations Manager and/or supervisor for follow-up regarding bills, substandard documentation and missing forms. * Notifies Operation Manger of any transport not meeting medical necessity. * Meet with crew-members demonstrating a need for additional documentation remediation and record training sessions for employee files as required by leadership. * Notify the billing office of any repetitive transport not meeting medical necessity. * Maintains files in an orderly fashion. * Contact physician offices, medical record clerks etc. as needed to obtain correct patient/transportation information. * Maintain confidentiality of ALL patient, employee and corporate records and information in accordance with all HIPAA and any other governmental/administrative policies/procedures/regulations. * Complete other duties as assigned. * Exhibits excellent customer service skills and behaviors toward internal and external customers and co-workers. * Adheres to department customer service and performance standards. Knowledge Skills and Abilities Required: * Minimum Education: High School Diploma or Equivalent. * Minimum Work Experience: Must have three to six months of work experience and basic knowledge of office procedures. Ability to work well with the public. Excellent customer service skills and the ability to work in a team based environment. * Contact with Others: Works closely with Crews, Front-end supervisor and Operations Manager, as well as various other hospital departments and physician practice offices. * Analytical Demands: Must have the ability to organize work activities to ensure efficient use of time and acceptable productivity. * Certification, Licensure, Registration: None required. Working Conditions: * Physical Effort: Mental, visual stress related to computer input. Viewing of computer screens and printed material for prolonged periods of time. Lifting limited to a box of forms weighing 10-12 pounds. Prolonged periods of sitting. * Work Environment: Normal office environment with limited exposure to health or accident hazards. * Equipment Used: Computer, printer, scanner, telephone, calculator and other assorted office equipment as well as insurance communications systems. Working Relationships: * Reports to Front-End Billing Manager and Operations Manager. The above primary job duties and responsibilities describe the level and nature of work performed by the employees assigned to this job. The description should not be construed as an exhaustive listing of all job duties and responsibilities performed by this job.
(USA-OH-Cincinnati) Gatekeeper (Billing and Documentation)
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