Job Description

Job Description

Job Description

Description:

Job Duties:

• Educate beneficiaries and MTF staff about the various billing and collection programs and processes to include the requirement of a DD Form 2569, Third Party Collections – Record of Other Health Insurance, and the required complete of an Injury Log.
• Facilitates procedures and processes for Third Party Collections, Medical Service Account and Medical Affirmative Claims IAW DoD 6010.15-M, Military Treatment Facility (MTF) Uniformed Business Office (UBO) Manual.
• Uses other databases (internal or external to MTF) in compliance with HIPAA guidelines to identify insurance coverage.
• Obtains information if necessary through direct patient interviews or by telephone. Insurance companies shall be called for verification of benefits and coverage amounts and to obtain other requirements to be met for reimbursement.
• Inputs and updates patient insurance information in CHCS, AHLTA, or MHS GENESIS and TPOCS or into other databases required by the MTF. Insurance coverage information is obtained, entered into CHCS, and TPOCS or other Government standard system with insurance information for those beneficiaries with billable coverage.
• Reviews medical records when needed for clarification of medical treatment, history of illness, medical tests, accident information or any other clarification for billing purposes.
• Prepares and mails or transmit claims to third party payers using the UB-92, the HCFA 1500, Health Insurance Claim Form, or other form required. Claims may also be processed electronically when available to the Government.
• Conducts follow-up claim inquiries until payment received and/or case is closed.
• Works with the facility Admissions and Dispositions Office to obtain authorizations and precertification's from third party payers.

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• Education. High School diploma or General Educational Development (GED) equivalency. Basic medical terminology required.
• Experience. At least two years relevant experience or specialized Registered Health Information Technician (RHIT) or Registered Health Information Administrator certification required.
• Certification: BLS Certification through the American Red Cross or American Heart Association

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