San Antonio, TX 78234 US
Currently recruiting an Accounting Clerk to provide administrative support services at Joint Base San Antonio (JBSA) - Fort Sam Houston in San Antonio, Texas. Hours of operation are from 0600-1800 not to exceed 40 hours per week or 80 hours in a two-week period. Duty hours include a thirty minute or one-hour (non-compensable) lunch break.
DUTIES OF THE ACCOUNTING CLERK:
- Contacting insurance companies regarding inpatient and outpatient claims telephonically or in writing for claims that are 30, 60, 90, and 180 days in non-payment status or considered delinquent per Uniform Business guidelines.
- Verifying that patient insurance information is correct in system and/or on claim forms. Research issues identified and correcting any claim that have problems per the insurance company.
- Maintaining, inputting and tracking each claim processed in billing system. Submitting TPC claims to MEDCOM JAG for review maintaining open TPC for accounts receivable less than 2 years. Verifying payments received in accordance with benefits quoted.
- Copying and mailing medical documentation for insurance companies as needed and/or as requested in support of appeals. Inputting notes of insurance information claim status, payments and/or explanation of benefits received on the accounts. Follow up on pending insurance claims every 30 days and notating account status in billing system until closed.
- Management of correspondence to patients and insurance companies and updating the billing system.
- Performing debt management procedures IAW MEDCOM RM debt management guidance.
- Conducting follow up actions on all self-pay bills at 30, 60, 90-day interval, as outline in DOD 6010.15, AR 40-400 and MEDCOM/FMR Debt Management directives and generating delinquent letters for claims not paid in a timely manner.
- Researching all returned mail to verify that the correct mailing address was utilized when the original bill was forwarded to the patient. And/or contacting the patient to determine the correct mailing address.
- Submitting claims eligible for transfer to the appropriate agency for collection within 90-120 days utilizing the billing and collection system.
- Responding to patient inquiries concerning their bills, by telephone or in writing within 72 hours and document communication with customer in the notes portion of the billing system.
- Generating forms utilized for payroll deductions for DOD patients who fail to pay their bills in a timely basis. Reviewing and verifying that all accounts transferred to OFAS are assigned the appropriate Reimbursement Source Code (RSC) and accounting classification.
- Processing remaining balances that are uncollectable per guidance to MEDCOM in the billing system with the appropriate codes.
- Generating industry standard healthcare claim forms for outpatient, inpatient services, and observation and ambulatory procedures as needed.
- Reviewing and retrieving supporting documentation for billing, filing, copying and auditing; mailing invoices and receipts to patients; maintaining the accounts to ensure the proper patient category is assigned to the patient; coordinates with the clinic coder to clarify questions pertaining to documentation of the encounter.
- Managing documentation for billing civilian emergencies with or without insurance and coordinating with payers for receipt of timely authorizations for care and any information sharing as required.
- Producing copies of billing documents to satisfy release of information requests.
- Processing and following up on interagency bills generated by the billing system as directed by management, utilizing the billing guidelines established in DoD 6010-15, Military Treatment Facility Uniform Business Office (UBO) Manual, AR 40-400 and the DHA Uniform Business Office Procedures Manual dated 24 October 2017. This would also include any subsequent revisions of any of the listed documents.
- Reviewing payments received in accordance with benefits quoted by the payer' s Explanation of Benefits (EOB). Submit a timely appeal to the payer for instances where total charges not received.
- Identify and report to the Chief, UBO recent trends of denials as a result of the errors generated during claims submission.
- Identifying billing errors and/or posting errors utilizing the Explanation of Benefits (EOB). Correct billing and posting errors within 48 hours. Identify complex dispute issues to the MSAO review.
- Obtaining current Health Insurance information from patients via telephone, letter or payer portal, when appropriate.
- Reviewing and managing billing errors for processing of medical claims daily. Ensuring partially paid or denied inpatient claims that are 120 days post billing and outpatient claims that are 60 days post billing are referred to MEDCOM JAG. After the claims are written off in billing system to MEDCOM JAG, review the claims for correctness before the claim files are transferred to MEDCOM JAG for further action. Respond to requests for additional information/claims from the JAG.
- Researching refund requests and credit balances to determine if refund is warranted. If validated, initiate, and post the refund action when required.
- Responding to requests for W-9s from Third Party Payers, ensuring 1099s for withholdings are complete and accurate.
- Researching and maintaining current benefit plan information for all payers.
- Assist the UBO leadership with reoccurring and as needed reports to include the annual trauma, annual secretarial designee, internal workload and monthly Region reports.
- Prescribing accounting standards, policies and requirements.
- Examining and interpreting accounting data, records and reports.
- Assisting and/or advising management on accounting and financial management matters.
- Verify incoming insurance documents, scans into billing system and contacts payers and/or patients regarding covered benefits with 72 hours of notification. Document the billing system, any pharmacy and medical benefits prior to billing.
- Calling the payer to verify coverage; generating correspondence mailed to the patient regarding forms with incomplete information; and interviewing the patient when information is unclear.
- Working closely with MTF departments for return visits to obtain additional insurance information that need to be pre-certified by payee(s).
- Picking up all incoming mail; opening and distributing correspondence within the office; maintaining a daily log showing the receipts of the various checks; scanning payment methods and EOBs; and assisting with sorting/preparing office files daily.
- Ensuing all negotiable instruments are secured when not in view and/or safely stored in the safe when departing the area.
QUALIFICATIONS OF THE ACCOUNTING CLERK:
- Possess one year experience with insurance billing, collecting, and/or basic understanding of inpatient, outpatient, and observation coding.
- High School Diploma or GED
- US Citizen (for access to government computer systems)
COMPENSATION & BENEFITS:
- Competitive pay
- 10 days paid time off per year plus 7 sick days per year
- 11 paid Federal holidays
- Health & Welfare allowance contributes to the cost of health insurance, long and short-term disability, and life insurance
- Dental and vision plans offered, 401(k)
ABOUT THE ARORA GROUP:
The Arora Group is an award-winning, Joint Commission-certified nationwide healthcare services company that, for almost 30 years, has provided medical care for the men and women who serve our country in the U.S. Armed Forces. Our mission is to provide world-class care and give our healthcare professionals opportunities to improve their skills, learn from the best, and serve the needs of active duty service members, their families, and veterans.
EOE AA M/F/Vet/Disability