Responsible for charge entry as assigned including timely and accurate posting of charges via TES, BAR and Anesthesia Module. The Jr. Account Representative will be working out of our Yonkers office.
Review anesthesia records thoroughly prior to charge entry and organize records by physician in room order and by time
Reconcile each charge to the surgical schedule to avoid duplication and posting in wrong service date
Verify that the primary procedure and physical status modifier is indicated and determine the correct billing area for categorizing the charge
Provide other QA on the anesthesia record including documentation of continuous time, missing modifiers, missing codes for invasive lines or qualifying circumstances, unlisted procedures that must be returned to coding
Link diagnosis codes to correct CPTs based on coding directives and notify supervisor of ICD-9s that are not sex appropriate that must be returned to coding
Verify that donor and recipients are linked for transplant cases and attach negotiation letters and authorization memos to anesthesia record
Select the appropriate FSC when entering family planning procedures for Medicaid PHSP enrollees and monitor FSCs based on the practice’s enrollment status
Run anesthesia module calculation report and help supervisor to resolve edits
High school graduate or equivalent with minimum of three to five years prior related work experience in physician practice plan or hospital business office preferred OR Bachelor's degree with one-year experience.
Ability to operate electronic claims processing system.
Must be knowledgeable regarding detailed claims preparation and payer specific billing requirements and reimbursement guidelines.
Must have a good understanding of medical terminology and medical records coding, third party payer guidelines and reimbursement practices and available financial resources for payment of balances due.
Must demonstrate excellent interpersonal, organizational, and communication skills.
Must be able to communicate with patients, payers, outside agencies, and the general public through face to face, telephone, and written correspondence.
Must demonstrate ability to effectively problem solve and make independent decisions.
Requires prior work experience on personal computer, electronic calculator and various general office equipment.