Overview
The Receipting and Billing Administrator is responsible for ensuring the accurate and timely processing of financial transactions and third-party compensable billings. This role requires strong attention to detail, effective communication skills, and the ability to manage multiple tasks efficiently daily.
Responsibilities
- Receipting Tasks (60%):
- Ensure accurate and timely processing of financial transactions.
- Maintain up-to-date records.
- Manage multiple tasks efficiently on a daily basis.
- Third Party Compensable & Surgical Billings Tasks (40%):
- Accurately raise and submit invoices to third-party insurers.
- Ensure all invoices are processed with accurate information.
- Submit invoices through appropriate channels to ensure timely and correct payment.
A - Key Billing Responsibilities:
Invoice Preparation and Submission:
- Current Insurer Details Check: Open the patient file and verify current claim details, ensuring they align with past billing history.
- Approval Validation: Locate and confirm the validity of the approval for the date of service and the service provided within the patient file.
- Referral Validation: Confirm that the referral addressed to the doctor is valid for the date of service from the demographics screen.
- Invoice Generation: From the appointment screen, highlight the patient to be billed and select the dollar sign ‘$’ box to generate the invoice.
- Invoice Addressing: Select the appropriate addressee for the invoice from the top left corner boxes.
- Item Number Addition: Include item numbers on the invoice, ensuring each item appears on a new line.
- Notations and Overrides: Add any required notations and overrides from the item number screen, accessible when adding the item number or by double-clicking on the item line.
- Transmission Method: Confirm the channel for sending the invoice using the Contact List
- Email Invoice Transmission: When sending invoices via email, include the patient name and claim number in the subject line, attach the invoice and any relevant documentation, and send.
- Electronic Transmission: For DVA and bulk bill claims, follow the steps to transmit electronically via File-Maintenance and Reports, selecting the appropriate options for provider, Medicare/DVA, and transmission creation.
- Third Party Compensable Consult Billings
As per General Elements +
- List Confirmation: Coordinate with the Diary Manager to confirm necessary checks have been completed and accounts are ready for invoicing by 11am the next working day.
- Billing History Check: Log into Genie, search and highlight the patient, and use 'Ctrl H' to review past invoices and their billing destinations.
- Rate Confirmation: Confirm correct billing rates using the Contact List (Q:\\PH\\Reference\\UPDATED CONTACT LIST, Insurer Contact tab) and amend rates from the item number screen if necessary.
As per General Elements +
- List Confirmation: Coordinate with the Surgical Manager to confirm necessary checks have been completed and accounts are ready for invoicing by 11am the next working day.
- Ensure that all operations reports are received from doctors
- Match operations report against signed surgical quotation or approval. Ensuring procedure and acceptance is all matched prior to invoice being raised
- Raise invoices with correct item numbers as per doctors instructions or templated item numbers held on file
- Ensure that for private patient invoices that the invoice / operations report / quote all match.
- Transmit Approval / Operations Report / Invoice – to Third Party Compensable accounts
- Receipt quote deposit to the invoice raised, ensure that both are clear and no deviations
- Transmit Invoice/Receipt to patient – if is a private surgery account
- Compliance and Documentation:
- Adhere to all relevant billing rules and regulations, including specific requirements for different types of consultations and procedures.
- Maintain accurate documentation of all billing processes and procedures, ensuring all steps are followed as per the SOP.
B - Key Receipting Responsibilities:
- Daily Bank Reconciliation:
- Match bank statements against remittances and Genie.
- Ensure payments are applied to the correct payee account, on the correct date, and against the correct invoice.
- Complete bank reconciliation fully and promptly each day.
- Daily Deposit Management:
- Close off all deposits daily with minimal items carried forward.
- Ensure all deposits are cleared no later than the 2nd working day of the following month.
- Daily Financial Reporting:
- Update the Finance deposit spreadsheet with the latest receipting information daily.
- Update the Medical Report spreadsheet daily by 11:00 am with the latest receipting information.
- Communicate surgical deposits to the relevant parties daily.
- Daily Remittance Tracking:
- Follow up on missing remittances to ensure all payments are accounted for daily.
- Address TAC payment errors and manage Medicare rebate errors in coordination with the Diary Managers (DM) daily.
- Apply credit for rounding credits up to $1 daily.
- Prioritize and respond to receipting queries, including miss receipting, short payments, or non-payments daily.
Score scale: 1- Nice to have - 5 Critical
Personal Qualities:
- Score 5 - Strong attention to detail and accuracy in data entry.
- Score 5 - Excellent written communication skills.
- Score 4 – Strong verbal communication skills
- Score 5 - Ability to work independently and as part of a team.
- Score 5 – Ability to manage multiple tasks and meet daily deadlines
Experience / Qualifications:
- Score 5 - Proven experience in finance administration or a similar role.
- Score 3 - Proficiency in using billing systems such as Genie.
- Score 4 - Experience in the healthcare industry.
- Score 3 - Knowledge of third-party insurance billing processes.
- Score 5 - Proficiency in enterprise software and spreadsheets