Billing Research Specialist-Journal Center, (1456)

Tricore; Albuquerque (NM); On-site; USD 20,664 - 34,440; Full time

Benefits offered by this job

Robust medical, dental, and vision insurance

401(k) Retirement Plan with employer matching

Lucrative Paid Time Off (PTO)

Job summary

Tricore is looking for a Medical Data Entry Specialist in Albuquerque, New Mexico. The position involves performing billing research functions, ensuring requisitions are ready for billing, and troubleshooting problems.

Candidates should possess a high school diploma, with a minimum of one year of medical billing experience, as well as knowledge of ICD-10 and CPT coding.

Benefits include medical, dental, vision, life insurance, 401(k) matching, and generous paid time off.

Qualifications

• Minimum one year experience as a Medical Data Entry Specialist.
• Minimum one year laboratory or medical billing experience.
• Two years experience in a healthcare medical office.

Responsibilities

• Perform billing research functions and problem solving.
• Enter billing information into the billing system.
• Track and log missing or inaccurate information.

Skills

Medical terminology knowledge

Intermediate data entry skills

ICD-10 and CPT coding

Effective communication

Education

High school diploma or equivalent

Tools

Microsoft Office

Internal computer systems

Internet Explorer

Job description

Schedule: Monday-Friday 8:00AM-5:00PM with other shifts as needed

Location: Journal Center

Salary/Hourly: Hourly Position

Job Summary

Performs billing research functions to ensure the requisition is ready to bill. Determines appropriate billing codes needed, billing information for data entry of requisitions, and other billing tasks. High degree of initiative and self-motivation needed to be able to troubleshoot billing problems without assistance on a frequent basis. Monitors, summarizes, and reports deficiencies in requisition information received from TRL offsite locations and ordering physicians/clients.

Essential Functions

1. Performs billing research functions and problem solving activities utilizing internal computer systems and Internet sites as appropriate by locating missing requisitions, status inquiries for patient/client accounts, calling on problems, verifies insurance and diagnosis information, and resolving discrepancies.
2. Determines validity and necessity of obtaining an Advance Beneficiary Notice (ABN) and Uninsured Patient Letter.
3. Enters billing information into billing system and other Business Office applications for scrubber edits (i.e. Rhodes Fusion Scrubber, Antrim, Fast Orders etc.) as appropriate.
4. Meets all Quality Assurance (QA) and production goals.
5. Tracks, logs and provides feedback to appropriate area on missing or inaccurate information by client and/or offsite location. Documents and communicates to Supervisor/Lead to initiate problem solving.
6. Prepare billing reports and perform data analysis of various types, as requested.
7. Communicates effectively and professionally to customers (internal and external). Maintains confidentiality of patient and client information.
8. Perform general clerical functions. Make photocopies; maintain appropriate records, files, and destruction of documents.
9. Responsible for following TriCore safety, personnel, and billing department policies.
10. Participate in training as directed by Supervisor/Manager.

Minimum Education

• High school diploma or equivalent.

Minimum Experience

• One (1) year experience as a Medical Data Entry Specialist in the TriCore Business Office.
• Minimum of one (1) year laboratory or medical billing experience.
• Minimum of two (2) years’ experience within a healthcare medical office in a registration or clerical position.

Other Requirements

• Intermediate knowledge and understanding of medical terminology, third party billing requirements, ICD-10 and CPT coding experience.
• Intermediate PC/data entry skills to include Internet Explorer and Microsoft Office applications.
• Must type 30 WPM or 9000 keystrokes per hour (typing test required).

Benefits

• Robust medical, dental, vision, life insurance, and many supplemental plans
• 401(k) Retirement Plan with employer matching
• Lucrative Paid Time Off (PTO) and nine paid holidays per year