Job DetailsJob Location: Ganado, AZ 86505Position Type: Full TimePosition Summary: Under the general supervision of the Business Office Manager, the Account Representative is responsible for the billing, collection, and reconciliation of accounts, and educating related departments about the billing/collection/reconciliation processes to ensure that clean, collectible claims are sent to payers in a timely manner. This list of duties and responsibilities is illustrative only of the tasks performed by this position and is not all inclusive. Essential Duties & Responsibilities: •   Review patient’s accounts to determine the status of the account. •   Make standard adjustments. •   Prepare and process a variety of documents necessary for the maintenance and follow-up of all outstanding patient’s accounts. •   Examine accounts for accuracy, adequate documentation, and compliance with regulations. •   Telephone third party payers regarding amounts that are due. •   Perform follow-up procedures in a timely manner in accordance with hospital Business Office policy and procedures. •   Generate contractual adjustment documents, when appropriate.  •   Identify accounts that are deemed non-collectible and make appropriate adjustments. •   Report any discrepancies to the Dental Director providing all supporting documents and recommending resolution. •   Generate monthly reports and close month by the first week of the following month and submit to the Finance Department.  •   Help with Dental Receptionists, as needed. •   Perform other duties as assigned.  QualificationsMinimum Qualifications: •   High School Diploma or General Equivalency Diploma. •   Diploma or certification in Medical Billing preferred. •   12 months of experience working within the healthcare setting. •   Demonstrated knowledge of billing workflows, payer rules, and claims submission processes preferred. •   Must be able to successfully pass the Employee Health Screening requirements and background investigation.    Knowledge, Abilities, Skills, and Certifications: •   Knowledge of Medical and Dental Terminology. •   Knowledge of ICD-9, CDT coding and ICD-10.  •   Ability to organize and keep records/files, MS Office Programs. •   Knowledge and understanding of Third-Party reimbursement/claims processing and follow up processes. •   Knowledge of the Meditech computer system, Dentrix dental software, and MS Office. •   Ability to read and understand aging reports and use them to target accounts for concentrated collection efforts. •   Ability to exchange ideas and information in a timely, concise, effective, and interpersonally appropriate manner. •   Demonstrate action and behavior that contribute to creating an environment where all individuals are treated in accordance with the mission & value statement. •   Ability to model Sage Memorial Hospital mission, values, and ethical standards and to perform work responsibilities in an effective, timely and efficient manner. •   Ability to understand departmental and organizational goals and to effectively prioritize and perform work responsibilities in a manner which best achieves those goals. •   Knowledge of the Joint Commission, HIPAA, Federal State and Local regulations including Workers Compensation and OSHA regulations. •   Ability to perform tasks without constant supervision, the delivery of assigned work on a timely basis, and follow-up of all assignments, on a timely basis. •   Ability to ensure neatness, completeness, thoroughness and organization of work and work habits. This work must be completed without errors or omission. •   Ability to speak the Navajo language and/or a familiarity with the Navajo Way.    Physical Demands: While performing the duties of this job, the employee regularly is required to sit; use hands to reach and grasp objects; reach with hands and arms; and talk or hear. The employee frequently is required to walk. The employee occasionally is required to stand; and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 50 pounds.    Work Environment: The employee will work in a Patient Care/Office Environment with moderate noise level. Normal scheduled hours are four, 10-hour shifts: Monday – Thursday or Tuesday – Friday.
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