Billing Research Specialist-Journal Center,… at TriCore… · Albuquerq…

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. The above statements describe the general nature and level of work being performed by individuals assigned to this classification. This is not intended to be an exhaustive list of all responsibilities and duties required of personnel so classified. MINIMUM EDUCATION: High school diploma or equivalent. MINIMUM EXPERIENCE: Requires one of the following: 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) TriCore is New Mexico’s largest laboratory, employing more than 1,400 individuals who serve in a broad range of positions. We are dedicated to improving the quality of care for our communities, and also our employees. We foster a culture of integrity, are dedicated to excellence, and are looking for passionate individuals with a desire to have an impact in patient care, the core of our strategy. We offer excellent benefits including, medical, dental, vision and life insurances, 401(k) retirement plan with employer matching, PTO, and paid holidays, as well as opportunities for continuous learning, education assistance, wellness programs, career advancement, and the ability to share in our genuine commitment to the health of our communities. We offer a variety of shifts at multiple locations.