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Performs daily routine monitoring of services for accuracy. Utilizes the electronic health report system to review, manage and approve services documented within the EHR ensuring compliance. Reports any discrepancies to the appropriate personnel within a timely manner. Works collaboratively with billing and clinical department staff to assist in the completion of daily requirements in the finance department. Communicates with department lead in a bi-weekly/monthly basis.
1. Communicate directly with rendering providers on a daily bases to acquire/confirm irregularities within service(s) documented in the EHR, via encrypted email.
2. Acquire Knowledge of all Behavioral Health and Physical Health documentation workflows related to regulation/requirements.
3. Review all services for accuracy on items such as duration, appropriate service type selection, encounter form requirements, but not limited too.
4. Report, manage and follow up with any irregularities found to rendering providers within a timely manner, to ensure timely submission to the insurance carrier(s).
5. Utilizing the EHR, create to do item(s) for any rendering provider’s service(s) needing corrections/update. (following the appropriate workflow)
6. Work collaboratively with all in house department(s) to ensure accuracy of all services rendered, assisting with the submission of a clean claim.
7. Work collaboratively with rendering provider to manage updating of any service documented. While managing all pre-approval reports in a daily timeframe.
8. Maintain a high level of customer service and professionalism both in dealing with the public and within the organization.
9. Approve all services documented within the EHR in a daily basis utilizing workflows and all pre-approval reports.
10. Retrieve information from EHR in order to acquire and complete all approvals on the same day of documented service.
11. Create and manage performance review on all service completed on a monthly basis specific to each individual provider. Once completed email all appropriate parties.
12. Attend bi-weekly/monthly department meeting with department lead, during which time all barriers, successes, updates, and performance will be reviewed/covered.
13. Develop an understanding of trauma and how it impacts others.
14. Incorporate trauma informed practices into job duties and responsibilities, including interactions and communications with others.
15. Be an active member of BCC’s culture of caring through positive and engaging social interactions.
16. Perform all other related duties and responsibilities as assigned.
Bachelor’s degree or Certified Professional Coder (CPC) or Certified Billing Professional (CPB) required.
Minimum of three (3) years billing/coding experience in the Health Care Industry required.
General knowledge of insurance plans required.
Computer and billing software program experience required.
Excellent written and verbal communication skills.
Knowledge of or experience with trauma-formed approaches preferred.
All offers of employment are contingent upon the following: 1) Receipt of results of a satisfactory drug and alcohol screening test. 2) Receipt of the originals of the following background checks: PA State Police Criminal History, PA State Child Abuse, and DPW FBI Criminal History. These clearances must be valid within the 12 months prior to employment. A conviction is not a bar to employment, however a review will be conducted to make a determination of employment should a conviction be present. 3) Receipt of original documentation and verification of relevant degrees, diplomas, certificates, or licensure. 4) Confirmation that you are not on the OIG Federal Healthcare Program Exclusion from Participation list. Should you appear on this list, Berks Counseling Center is prohibited from employing you.