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Business Office Representative I / II (Full-time)

Company: Boulder Medical Center
Location: Boulder
Posted on: May 7, 2022

Job Description:

Job DescriptionDo you enjoy working with friendly and helpful people in a positive work environment? Are you ready to embrace a career as a Patient Account Representative that offers a variety of learning opportunities? Are you looking to make a positive impact on peoples' lives in our community?Consider a career in the medical field at Boulder Medical Center (BMC). We're an independent, multi-specialty, outpatient network of providers and staff dedicated to engaging our patients in high-quality, compassionate health care. For over 70 years, BMC has been locally owned and operated, providing exceptional medical care to patients across the northwestern Front Range and surrounding communities. This unique business model is why many of our employees come and stay!SummaryBoulder Medical Center (BMC) is seeking a Business Office Representative to join our team! This position works full-time 40 hours per week Monday through Friday and is benefit eligible. The ideal candidate for this position will have past medical provider billing experience and past experience dealing with medical claims. Under the direct supervision of the Business Office Coordinators, Assistant Manager, and the Business Office Manager, the BO Representative performs any or all related duties, in accordance with Business Office policy and procedures.Job Responsibilities

  • Follows protocols and business practice guidelines established in BMC's Business Office department manual. Explains the different types of insurance coverage to patients and co-workers. Establishes and maintains a working knowledge of BMC contract insurance carriers and their billing requirements, as needed.
  • Establishes and maintains a working knowledge of the Accounts Receivable system. Understands and uses appropriate forms for charges, adjustments, payments, error corrects, error removals, balance transfers, refunds, refund reversals, and communications forms. Able to reconciles account balances by financial class, able to print ledgers and claim forms, explain statement and insurance processing along with their related computer screens to patients, carriers and co-workers.
  • Is able to access and understands NextGen's scheduling and EHR.
  • Understands the patient registration process. Uses chart/account alerts to capture accurate patient/account information and consistently updates or creates the account, patient and insurance records in a timely manner.
  • Consistently uses account notes to document patient status/conversations and chart notes to document claim progress.
  • Ensures timely and accurate processing of charge sheets. Reviews documents, makes corrections or additions and delivers charges to medical billing within established guidelines.
  • Receives insurance claim forms. Accurately reviews forms for discrepancies and errors. Makes appropriate changes or additions in a timely manner and submits claim forms to carriers. Shows consistent effort in maintaining clean claims and constantly attempts to expedite the payment process. Understands claim type codes.
  • Consistently documents errors and changes made to account transactions and notifies appropriate personnel when consistent errors are found in the claims review process.
  • Demonstrates an understanding of medical terminology and grasps its importance in accurate documentation, claims submittal and reprocessing.
  • Demonstrates a working knowledge of the current procedural terminology (CPT), including the CPT modifiers. Reviews CPT appendixes yearly to update additions, deletions and revisions to the terminology. Demonstrates a working knowledge of the international classification of diseases (ICD-10).
  • Establishes and maintains a working knowledge of the relative value system. Demonstrates an understanding of the unit value and is able to calculate fees in accordance with established guidelines. Able to access and understand the pricing tables and support tables.
  • Demonstrates a working knowledge of insurance billing procedures guidelines, including OB protocol, to understand global surgery values and guidelines, separate procedures, multiple and bilateral procedures, modifiers, and able to estimate approximate reimbursement levels.
  • Demonstrates knowledge of and ability to recognize specialized accounts such as: Motor Vehicle Accident (MVA), Work Comp (WC), Company, Collection, and Working Accounts.
  • Receives, reviews and maintains files of current NextGen reports. Works aged trial balance, claim worklists, untagged, insurance overpayment, prepayment, unapplied payments, claim acknowledgement, claim rejects, and other daily/weekly reports as deemed appropriate.
  • Remains updated and fluent with bulletins and newsletters pertaining to their particular specialty. Consistently evaluates the information and shares valuable information with supervisors and co-workers. Attends product seminars when requested.
  • Understands the select process and utilizes database queries to update and maintain accurate patient and insurance records. Able to access and generate claim forms.
  • Covers the Business Office reception desk when called upon. Understands the BMC Credit and Payment Policy, able to take a credit card payment, co-pay or prepayment.
  • Understand and competently operates the Electronic Medical Records system.
  • Attends mandatory Electronic Medical Records training.
  • Participates in on-going Electronic Medical Records learning opportunities.

    Skills and Abilities:
    • Accurate typing
    • Computer experience
    • Operate office machines
    • Operate adding machine
    • Basic math aptitude
    • Detail oriented
    • Patience - Tact - Pleasant telephone voice and manner
    • Ability to initiate correspondence using appropriate grammar, etc.
    • Ability to coordinate the activities of the department.Education:
      • High school diploma or equivalent required. Course in Medical Terminology, Business, or Accounting helpful. Previous Experience:
        • 1-2 years Health Insurance experience or equivalent background. Salary Range:
          • $16.54 - $22.57 / hour; depending on experienceLocation:
            • Boulder, CO

              Benefits:BMC offers a comprehensive benefit package for full-time employees that includes medical/dental/vision, flexible spending, company-paid life insurance and STD as well as voluntary benefits, RTD EcoPass, 401(k), Paid Time Off and 6 holidays annually. Part-time employees are eligible for medical/dental/vision, company-paid life insurance, voluntary benefits, RTD EcoPass, and 401(k).

Keywords: Boulder Medical Center, Boulder , Business Office Representative I / II (Full-time), Administration, Clerical , Boulder, Colorado

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