Work in Washington Veterans Jobs

The Business Office Representative provides support for the Business Office. Most work at this level involves enrolling for and maintaining continuing health coverage eligibility for clients in the WA Healthplanfinder system. As needed, assist with billing, front desk coverage, and Purchased Referred Care (PRC) duties. This position is regular and full-time.

Duties For Billing Assistance Include:

• Enter data and post charges in NextGen.
• Re-bill denied and aged claims.
• Register and update patient insurance information and demographics in NextGen.
• Ensure patient data and insurance information gets updated on the PRC member roster. A/R posting of third-party payments.
• Process, print, and mail forms as needed.
• Participate in on-the-job training and any meetings, workshops, or seminars related to third-party billing issues.
• Monitoring Medicare and Medicaid newsletters and other third-party newsletters are imperative to ensure compliance with billing rules and regulations. Understanding and knowledge to provide correct insurance information to other department staff are essential.

Duties For Tribal Assister Include:

• Conducts patient outreach and information gathering to determine appropriate insurance services for the patient.
• Conducts interviews to input patient eligibility information into agency systems for those agencies to determine eligibility for medical benefits.
• Explains program requirements and services available. Refers clients to both mandatory and optional services and other agencies as required.
• Detects discrepancies and clarifies data through telephone inquiries, correspondence, and interviews. Recognizes and recomputes incorrect income for medical assistance.
• Works within time frames and deadlines that are dictated by program requirements.
• Attends and completes required training courses as mandated by the agency or the Tribe.
• Maintains active Tribal Assister certification.

Other Office Duties:

• Provide patient outreach for health coverage.
• Monitor verification and collection of patient demographics and insurance data when checking in at the health clinic and dental front desk.
• Monitor daily medical and dental schedules to ensure Medicaid and enrollment for other applicable health coverage happens at the time of the appointment. This needs to be coordinated with the PRC office to ensure patient information is accurate and regularly updated.
• Provide follow-up on private patient statements and incomplete PRC claims.
• When interacting with other billing offices, provide information and education on the PRC program. In coordination with the Billing Coordinator, work with the Tribal Sponsorship Program.
• Provide front desk coverage as needed.

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``` - Other duties as assigned by the Health Business Manager.

Qualifications:

Education:

• G. E. D. or High School diploma required.
• Thorough knowledge of ADA, CPT, and ICD-9/ICD-10 coding is needed.
• Six months of experience as a Medical Assistant Specialist 1 and Certified Tribal Assister, and completing the Tribal Assister Training Program required. Tribal Sponsorship certification is required. It may be obtained within the first year of employment.
• A good understanding of the operations of data processing and third-party billing systems used in a professional health clinic is necessary.
• Familiarity with medical and dental terminology is required.

Experience:

A minimum of one year of experience with third-party billing and data entry procedures used in a primary care clinic or similar setting is necessary.

Ability to analyze complex billing/data