Synopsis: Under the supervision of the Director/NIT Dept. of HHS, the incumbent is responsible for electronic and paper third party billing for the health center and interacting with State (Medicaid) and Federal (Medicare) agencies. The incumbent must have experience with billing Medicare, Medicaid and private insurance. The incumbent is also responsible for verifying patient insurances, following up with unpaid claims and accounts receivable reporting. Must be experienced and able to complete the credentialing process of NIHC and its providers with third-party insures. Must have a Coder certification and 3-5 years of billing experience in a medical office.

Summary: The incumbent will be responsible for accurate claim submission and billing of patient information to third party insurance agencies for payment and account receivable reports. The incumbent may also be responsible for routine administrative and clerical duties.

Essential Duties and Responsibilities: Must adhere to the Narragansett Indian Tribe's and Narragansett Indian Health Center's Policies and Procedures.

Responsible for third party billing of patient accounts. Process claims daily via paper and/or electronic submission. Ensures appropriate payment of all claims. Ensure timely processing of benefit information.

Must have experience and knowledge with multi- specialty billing.

Must have excellent knowledge of billing RI and CT Medicaid, Medicare, and private insurances.

Responsible for reviewing all third party payer bulletins and newsletters to ensure system compliance for billing.

Responsible for third party insurance verification.

Responsible for follow-up with insurance companies regarding un-paid claims by phone or on-line, denials of payment, and initiating appeals.

Re-bill claims as needed.

Routinely interacts with internal and external contact including patients, third party payers, government agencies, etc.

Managing the facility's Accounts Receivable reports. Posts contractual allowances and adjustments to appropriate accounts.

Responsible for new provider enrollment.

Cross train in the Office of Purchased and Referred Care Services.

Know, Understand, and Comply with HIPAA regulations.

Must have experience with electronic health record systems and willing to learn current electronic health system and RPMS.

Must be willing to travel, limited, for training.

Performs all other related and compatible duties as assigned.

Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. High level of Federal and State billing and reimbursement knowledge required.

Education and Experience: ICD-10 and medical coder certification required. 3-5 years of medical office billing experience required, electronic preferred. Proficient in Microsoft Office and QuickBooks. Certification of a Coder required. Previous experience with electronic health record system.

Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to walk; sit; use hands to finger, handle, or feel; reach with hands and arms to type using personal computers and will be subject to repetitive motion; and talk or hear. The employee frequently is required to stand and stoop, kneel, crouch, or crawl. The employee must frequently lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.

Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. The noise level in the work environment is usually moderate.

THE NARRAGANSETT INDIAN TRIBE PRACTICES TRIBAL AND NATIVE AMERICAN PREFERENCE IN HIRING AND IS AN EQUAL OPPORTUNITY EMPLOYER.

Additional Requirements: Excellent computer skills. Knowledge of medical terminology and experience with the electronic health record.

Supervisory Requirements: N/A

Language Skills: Must have the ability to communicate clearly and concisely both orally and written. Must have the ability to approach interpersonal relationships in a manner that avoids antagonism, reduces conflict, and prevents undue anxiety.

Mathematical Skills: Ability to calculate figures and amounts such as interest, proportions, percentages, etc. Ability to apply concepts of basic algebra.

Certificates, Licenses, and Registrations REQUIRED: Certified Medical Coder

Job Type: Full-time

Pay: $17.00 - $21.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

COVID-19 considerations:
We are taking a number of additional precautions including screening, outdoors testing, wearing masks, using dividers, safe distance, etc.

Ability to commute/relocate:

• Charlestown, RI 02813: Reliably commute or planning to relocate before starting work (Preferred)

Experience:

• ICD-10: 3 years (Required)
• Medical Billing and coding: 3 years (Required)

License/Certification:

• Medical Coding Certification (Required)

Shift availability:

• Day Shift (Required)

Work Location: One location

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