Summary

Audits front-end data elements of a more complex and advanced level relative to billing a clean claim. Reviews demographics, insurance information, provider identification information, and charge capture documents and systems for accuracy and completeness. Communicates findings to AR Supervisor to ensure applicable staffs are made aware of pre-bill audit findings. Working under limited supervision, adapts procedures, processes, and techniques to accomplish the more complex requirements of the position. Serves as lead by answering questions, conducting training, preparing educational materials, mentoring for Claims Services Reps. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.

Education/Experience/Licensure

Knowledge/Skills/Abilities

• Strong knowledge all data elements compiled on standard billing forms/data sets.
• Strong knowledge of Practice Management Systems and basic computer skills.
• Detail oriented, excellent prioritization and organizational skills.
• Ability to work without close supervision and to exercise independent judgment.
• Ability to organize multiple tasks and workflow for self and others as it relates to training, preparing educational materials, and providing guidance.

Key Job Responsibilities

• Serves in the lead capacity for Pre-Bill Auditor/Billers for the CBO.
• Performs more complex and non-routine reviews and reports findings to AR Supervisor.
• Submits more complex and non-routine claims to third party and governmental payers.

Physical Requirements

• The physical activities of this position may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion.
• Must have good balance and coordination.
• The physical requirements of this position are: light work - exerting up to 25 lbs. of force occasionally and/or up to 10 lbs. of force frequently.
• The Associate is required to have close visual acuity to perform an activity, such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading.
• The conditions to which the Associate will be subject in this position: The Associate is not substantially exposed to adverse environmental conditions; job functions are typically performed under conditions such as those found in general office or administrative work.