A/R Systems Administrator
Employment Type : Full-Time
The A/R Systems Administrator ensures that all phases of the AR billing systems set-up are performed and completed accurately. Job Summary:
The A/R Systems Administrator ensures that all phases of the AR billing systems set-up are performed and completed accurately. Responsibilities include: QMS Focus system set-up, maintenance, reporting and documentation. This position oversees implementation of new clearinghouse: all-payer eligibility verification system, electronic claims and billing system, including electronic remittance advice.
Essential Functions:
- Creates, maintains and tracks rate groups including quarterly, yearly, and contractual pricing updates
- Maintains Medicare Quality Initiative Program set-ups
- Adds and maintains Preferred Payment System set-up
- Creates adjustment codes
- Creates and maintains treatment items
- Adds and tracks HCPC and lCD10 coding
- Adds and tracks Medicare, Medi-Cal and commercial payer-specific coding
- Adds and tracks National Drug Codes
- Creates, maintains and tracks payer set-ups
- Creates, maintains and tracks payer crossovers set-ups
- Works with QMS representatives to create and revise claim templates per payer specifications, tracking activity
- Creates and maintains unit set-ups
- Creates and maintains ECS set-up
- Adds, maintains, deletes and tracks system user access
- Documents all activity as required for approval by Director of Reimbursement
- Submits documentation packets to A/R Administrative Assistant for lntact processing
- Reviews A/R reports, develops and continues to improve collection strategies; identifies problem payer trends and communicates to Directors of Reimbursement and Contracting; maintains DSO at acceptable levels
- Works with Director of Reimbursement to develop goals, objectives and competencies for A/R Teams and provides training and motivation as necessary to support Teams in meeting these goals
- Helps with overflow in other areas of A/R Department
- Responds to requests for reporting and analysis from Director of Reimbursement
- Insures the confidentiality of patient and employee information in compliance with HIPAA guidelines
- Responsible for driving the Satellite Healthcare culture through values and customer service standards
- Accountable for outstanding customer service to all external and internal customers
- Develops and maintains effective relationships through effective and timely communication
- Takes initiative and action to respond, resolve and follow up regarding customer service issues with all customers in a timely manner
Minimum Education & Experience:
- High School Diploma, GED or equivalent required; college courses or courses in insurance billing, data processing, or medical terminology preferred
- Two (2) years of experience in a medical collections environment
Minimum Knowledge, Skills & Abilities:
- Extensive knowledge in coding appropriate CPT/HCPCS and ICD10 codes in a medical billing environment
- Ability to analyze data
- Exceptional customer service to all clients
- Contributes to harmonious and constructive working relationships with all staff members to promote a positive and productive atmosphere
- Ability to understand and apply Medicare and Medicaid ESRD rules and regulations; knowledge with Medicare and Medicaid is preferred; understands the private insurance industry: PPO, HMO, POS, Medicare Advantage and lndemnity Plans
- Accurate keyboard and ten-key skills; must be literate in Microsoft based programs
- Ability to work effectively in a team environment and independently
- Positive attitude with excellent interpersonal skills
- Basic accounting and hands-on knowledge of accounts receivable computer systems in health services preferred
- Ability to organize workflow and manage a large volume of incoming documents accurately with a minimum of supervision, as well as possess ability to work cooperatively with others
- Able to read, write, speak, understand and satisfactorily communicate with others in English in person, over the phone and via email