Processes and enters charge information into database. Completes billing process and distributes billing information. Verifies insurance benefits and assists with referrals. May prepare checks for deposits. Monitors accounts receivable to maintain appropriate levels and reviews payments to maximize reimbursement. Interacts with patients, insurance carriers, the Billing Department and practice personnel concerning patient accounts. Performs all functions in a courteous and professional manner. Assures all appropriate licensure, certifications and/or accreditations are secured according to policy to include all credentialing issues related to the service.
- Coordinates all Insurance Authorizations for the service.
- Verifies and updates necessary information; enters patient demographics and insurance information into the computer.
- Review tickets for accuracy and completeness, determine appropriate fees for services rendered, calculate totals, collect appropriate amount from patients, properly record information. Responsible for posting hospital charges or other satellite services. Utilizes correct ICD9, CPT and HCPCS coding methods to determine the proper code for the services rendered.
- Responsible for cross-checking tickets and correcting all detected errors; notifies physician and patient of corrections. Reconciles daily charge tickets within established guidelines.
- Processes payments received in person and by mail. Records, totals and prepares monies for deposit according to company procedure.
- Makes adjustments to patients' account including editing charge entries and entering charge corrections, according to established procedures.
- May reconcile over-the-counter payments with daily input and makes adjustments as needed.
- Handles collection efforts for all outstanding accounts including patient calls and sending correspondence. Takes necessary steps to establish acceptable payment schedules or refer appropriate accounts to collection agency.
- May post over-the-counter payments to accounts (or NSF checks) for outstanding balances, including discounts, adjustments and write-offs.
- Obtains approval/arrangement of Budget plan booklets as established by policy or practice. Follows up to determine if payment arrangements are being met, contacts patients to resolve problems, responds to correspondence or telephone calls from patients about accounts.
- Follows up, either by telephone or in writing, with insurance companies and patients regarding the processing of outstanding claims and/or appeals.
- Reviews all Explanations of Benefits (EOBs) and initiates collection procedures for those with zero payments.
- Maintains NSF checks to ensure the applicable account is added back to accounts receivable, in accordance with NSF policies and procedures.
- Generates various reports necessary to manage accounts receivable, including denial reports, insurance follow up reports, NSF reports and month end reports.
- Communicates information to appropriate personnel. Educates staff on corrections, e.g. front-end entry errors in a positive, constructive manner.
- Collects and reviews managed care contracts for correct billing and payment terms.
- Identifies problem accounts and follows through to completion.
- Reviews EOBs to ensure proper reimbursement of claims and reports any problems, issues or payer trends to supervisor.
- Reviews credit balance reports for correct recipient of refund.
- Resolves patient billing complaints and questions, initiates adjustments as necessary.
- Participates in company sponsored collection forums and other educational activities.
- Helps fiscal management and other administrative staff in implementing cost effective policies and procedures for all areas including billing, insurance, fee schedules, credit/collections, purchasing, and data processing.
- Gathers and reports monthly and annual data for fiscal, statistical and planning purposes. Develops and implements revenue enhancement strategies for existing practices.
- Responsible for assuring all appropriate licensure, certifications and/or accreditations are secured according to policy.
- Follows the CHRISTUS Physician Group guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI).
- Maintains strict confidentiality.
- Uses oral and written communication skills to effectively convey ideas in a clear, positive manner that is consistent with the CHRISTUS Mission.
- Maintains established CHRISTUS Physician Group policies, procedures, objectives, quality assurance, safety, environmental and infection control.
- Implements job responsibilities in a manner that is consistent with the CHRISTUS Mission and Code of Ethics and supportive of CHRISTUS Physician Group's cultural diversity objectives.
- Supports and adheres to CPG Service Guarantee.
- Performs other related work as required.
- High school diploma or GED.
- Ability to operate 10 key calculator by touch.
- Knowledge of medical software systems.
- Ability to prioritize multiple tasks.
- Three years of accounts receivable experience including two years of experience in a health care organization; one year of experience in a managed care setting preferred.
- Working knowledge of ICD9, CPT and HCPCS coding.
- Knowledge of Medicare, Medicaid and Worker's Comp.
Healthcare Common Procedure Coding Systems
Based on Job Title, Location and Skills
See the next step in your career
Apply to this job.
Think you're the perfect candidate?
Help us improve CareerBuilder by providing feedback about this job:
Report this job
Report this Job
Once a job has been reported, we will investigate it further. If you require a response, submit your question or concern to our
Trust and Site Security Team
Job ID: 5000529900206
privacy and protection,
when applying to a job online, never give your social security number to a prospective employer, provide credit card or bank account information, or perform any sort of monetary transaction.
By applying to a job using CareerBuilder you are agreeing to comply with and be subject to the CareerBuilder
Terms and Conditions
for use of our website. To use our website, you must agree with the
Terms and Conditions
and both meet and comply with their provisions.
The two Congregations of the Sisters of Charity of the Incarnate Word in Houston and San Antonio share a common mission of providing the healing ministry of Jesus Christ, which began more than 130 years ago. The shared legacy of the two Congregations dates back to 1866 when three Sisters Religious came from France in response to a call from Catholic Bishop Claude M. Dubuis to come to Texas to help care for the sick and infirm. In the leading port city of Galveston, the Sisters founded the Congregation of the Sisters of Charity of the Incarnate Word and opened the first Catholic hospital in the state. In 1869, three members of the Congregation traveled to San Antonio and established Santa Rosa Hospital. Due to the distance between the cities and the problems of transportation at the time, the Congregation in San Antonio became a separate order with the same name as its founding Congregation.
View the full profile
The Congregations of the Sisters of Charity of the Incarnate Word in San Antonio and the Sisters of Charity of the Incarnate Word in Houston announced in September of 1997 their plans to work together toward combining the health care systems which each sponsors. In July 1998, the two signed a letter of intent, calling for all assets of the Sisters of Charity Health Care System (SCH) and the Incarnate Word Health System (IWHS) to become part of CHRISTUS Health. On February 1, 1999, that dream became a reality and CHRISTUS Health was born.
In 1972 Space Center Memorial Hospital opened to serve the 55,000 community members surrounding NASA Manned Spacecraft Center. The goal of the new hospital was "to return to the people of our country the benefits in the form of health service dividends produced from space exploration."
Unfortunately, the facility was closed in September 1974, only 13 months after it opened, by the Federal Housing Administration because the hospital was behind in mortgage payments. The hospital was unoccupied until the federal government took it over.
In 1981 Congress passed an administration bill, part of President Reagan’s budget-cutting proposals, that closed eight Public Health Service hospitals in the United States. The Houston-based Sisters of Charity of the Incarnate Word Health Care Systems was selected by the federal government to assume control of the U.S. Public Health Service Hospital in Nassau Bay. The government said Sisters of Charity was chosen because of its reputation for providing quality care for its patient population. The Sisters purchased the facility for $1.
On Dec. 9, 1981, CHRISTUS St. John Hospital treated its first patient. The founding sisters of the hospital, Sister Clare Marie, Sister Frances Therese, and Sister Edwin Berry, worked night and day to build St. John Hospital into the quality health care facility it is today. The hospital opened to serve the needs of the community, merchant marines, workers for the Department of Defense as well as Vietnamese and American shrimpers.
In 1982 CHRISTUS St. John Hospital was one of the first hospitals to have a layman, rather than a member of the Congregation, as administrator. Over the years, CHRISTUS St. John Hospital, located across from Johnson Space Center, has been under contract with NASA for provision of the medication kits for the Space Shuttle and for physiological testing for the space program.
A $9 million expansion that was completed in 1989 debuted the concept of LDRP suites in the Center for New Life, enlarged the emergency department and improved diagnostic imaging capabilities.
On Jan. 23, 1998, the hospital unveiled its new street name and address. Hospital Boulevard was renamed St. John Drive in an official proclamation from the mayor. The hospital’s founding sisters were forever memorialized in the new street address, since the "3" in 18300 was chosen to represent the three sisters.
CHRISTUS St. John Hospital has always been committed to the CHRISTUS Health Mission of extending the healing ministry of Jesus Christ through community involvement and programs. The hospital is responsible for establishing Point of Light Clinic, school-based clinics and Project Gabriel in the Dickinson and Nassau Bay areas. CHRISTUS St. John Hospital also received national attention with the development of its parish nurse program.
CHRISTUS St. John Hospital continues to offer quality acute care health services, has added specialties to serve the community, has actively recruited top physicians to fill the needs of Nassau Bay residents, and remains solid in the mission of mercy envisioned by its founding sisters 20 years ago.