JOB REQUIREMENTS

Education

High School Graduate or equivalent with training in spreadsheets and word processing required. Experience with Personal computers, billing and coding and patient accounting software is preferred.

Experience

Three-Five years of prior medical healthcare experience and/or knowledge of Determination of Managed Care Contracts, Payer Plans. Supervisory experience helpful. Health care, insurance, not-for-profit or governmental experience preferred.

Physical

This is a safety sensitive position. Please see the St. Bernards Substance Abuse Policy for further information.

Normal hospital business office environment. Extremely close eye work with Use of computer up to 8 hours a day. Moderate degree of disruption to routine, as need dictates. Moderate eye strain from computer screen. Must have reliable transportation, current drivers license in the state of Arkansas, and automobile liability insurance. Occasional overtime to meet report deadlines. Frequent sitting, standing, walking, and bending. Occasionally lift, carry, push, and pull maximum 50 lbs.

JOB SUMMARY

Responsible for assisting the Program Director, PCM, Patients, Coding Department and Business Office with resolving specialized issues that occur throughout the claim processing of patient accounts. Works specifically with Managed Care Team of Outpatient /Inpatient Wound Services to aid in education, training, productivity and work flow issues that occur intermittently and can hinder the billing, coding or claim processing. Assist the Director/PCM with reports and updates about issues that will delay or are delaying the patient account processing. There is a moderate level of decision making associated with this position, and a moderate degree of interaction with other hospital departments. This person must be able to use diplomacy and tact when interacting with other people while communicating issues that affect wound clinic operations. This position is responsible for a properly managed and organized billing of outpatient wound charges/insurance precertification for wound care procedures. This person must be well trained and knowledgeable in proper billing/coding policies and procedures of various payers. They must have the ability to quickly understand and work with various wound clinic billing and coding software, and they are expected to train wound office staff in the use of said billing and coding software. This person must be able to communicate effectively both orally and in written form. The person is expected at all times to portray a positive professional public image. Routinely, assigns and responsibly directs staff. This position is required to utilize independent judgment.