MEDICAL BILLING CLERK (NELLIS AFB) Job at Anthony & Associates, Inc. dba AAI
Medical Billing Clerk
Nellis AFB
Nellis AFB
AAI is actively recruiting a Medical Billing Clerk to support the 99th Medical Group located at Nellis AFB which operates one of the largest Air Force medical facilities in the Air Force, the Mike O’Callaghan Military Medical Center. Its primary mission is to maintain medical readiness for worldwide contingencies by providing quality, cost-effective health care for more than 48,000 enrollees, including almost 15,000 active-duty members.
This project will require the Medical Billing Clerks to monitor, manage and report on services for higher management and develops plans to improve timeliness and accuracy rates, service availability, and overall MTF performance and compliance.
RESPONSIBILITIES:
A Medical Billing Clerk will serve in the following departments, the Uniform Business Office (UBO) programs: Third Party Collections (TPC), Medical Services Account (MSA), and Medical Affirmative Claims (MAC). The Medical Billing Clerk initiates and processes claims for first or third-party payers on behalf of beneficiaries treated in MTFs. The Medical Billing Clerks must have the following mandatory
Requirements:
- Must speak the English language using correct grammar, spelling, punctuation, capitalization, and format to prepare and edit written correspondence, reports, and transcribed material.
- Standard office equipment, such as computers, typewriters, copiers, fax machines, telephone systems, and office automation systems, to perform a substantial range of medical billing support.
- General medical ethics, telephone etiquette, and excellent communication and customer service skills.
- Ability to read, interpret medical documentation, and understand medical terminology to correctly bill both outpatient and inpatient services.
- Work Environment/Physical Requirements. Requirements include prolonged walking, standing, sitting, or bending. Must be able to carry 25-50 pounds and reach high shelving units with the assistance of step ladders to retrieve and file medical records.
- Educate beneficiaries and MTF staff about the various billing and collection programs and processes including the requirement of a DD Form 2569, Third Party Collections – Record of Other Health Insurance, and the required completion of an Injury Log.
- Facilitates procedures and processes for Third Party Collections, Medical Service Accounts, 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 MHS GENESIS and TPOCS or into other databases required by the MTF. Insurance coverage information is obtained and entered into MHS GENESIS, TPOCS, or other Government standard systems 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 transmits claims to third-party payers using the UB-92, the HCFA 1500 Health Insurance Claim Form, or any other form required. Claims may also be processed electronically when available to the Government.
- Conducts follow-up claim inquiries until payment is received and/or the case is closed.
- Works with the facility Admissions and Dispositions Office to obtain authorizations and precertification’s from third-party payers.
REQUIREMENTS:
- A fully qualified typist (computer keyboard) with a minimum of 40 WPM is required.
- Knowledge of Ambulatory Procedure Groupings (APG), Diagnosis Related Groupings (DRGs), International Classification of Diseases-Version 10 (ICD), and Current Procedural Terminology- Version 4 (CPT-4) coding.
- Education. High School diploma or General Educational Development (GED) equivalency. Basic medical terminology is required.
- Experience. At least two years of relevant experience or specialized Registered Health Information Technician (RHIT) or Registered Health Information Administrator certification is required.
- Certification. Basic Life Support (BLS) certifications using American Heart Association or American Red Cross guidelines. Members must present proof of current certification(s) through American Heart Association or American Red Cross is required.
UNIQUE MILITARY HEALTH CARE SYSTEMS/PROCEDURES:
- The Government has three programs within the Uniform Business Office (UBO) three programs: Third Party Collections (TPC), Medical Services Accounts (MSA), and Medical Affirmative Claims (MAC).
- Armed Forces Health Longitudinal Technology Application (AHLTA).
- MHS GENESIS - specific to MSA, Other Health Insurance (OHI) input, and Third-Party Outpatient Collection System (TPOCS).
- Defense Enrollment Eligibility Reporting System (DEERS).
- Military Filing System - by sponsor social security number, terminal digit order, color-coded and blocked filing system.
- Contents of a military medical record, layout, sections, family member prefix designation, forms used in MTF, and the medical record tracking procedures.
About AAI
AAI is focused on delivering outstanding services to the federal government. We have extensive experience in the fields of cyber security, development, IT infrastructure, supply chain management, and other professional services such as system design and continuous improvement. AAI is a VA CVE-certified Service-Disabled Veteran-Owned Small Business (SDVOSB), SBA-certified Economically Disadvantaged Woman Owned Small Business (EDWOSB), and a Woman Owned Small Business (WOSB) with offices in Hampton Roads Virginia, Montgomery, AL, Washington DC, and Atlanta. Fully qualified candidates are welcome to apply directly on our website at: https://aaionline.us/.
Our benefits include:
- Paid Federal Holidays
- Robust Healthcare and Dental Insurance Options
- 401a plan
- 401k plan
- Paid vacation and sick leave
- Continuing education assistance
- Short Term / Long Term Disability & Life Insurance
Veterans are encouraged to apply
AAI does not discriminate in employment opportunities, terms and conditions of
employment, or practices on the basis of race, age, gender, religious or political beliefs,
national origin or heritage, disability, sexual orientation, or any characteristic protected
by law. Pending guidance from the Safer Federal Workforce, employees may in the
future be required to provide evidence of COVID-19 vaccination or request and receive
approval for a medical or religious exemption.
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