Charge Quality Auditor - Entry Level Medical Billing - Machesney Park

Experity offers the following:

• Benefits

• Comprehensive coverage starts first day of employment and includes Medical, Dental/Orthodontia, and Vision.

• Ownership

• All Team Members are eligible for synthetic ownership in Experity upon one year of employment with real financial rewards when the company is successful!

• Employee Assistance Program

• This robust program includes counseling, legal resolution, financial education, pet adoption assistance, identity theft and fraud resolution, and so much more.

• Flexibility

• Experity is committed to helping team members face the demands of juggling work, family and life-related issues by offering flexible work scheduling to manage your work-life balance.

• Paid Time Off (PTO) - Experity offers a generous PTO plan and increases with milestones to ensure our Team Members have time to recharge, relax, and spend time with loved ones.

• Career Development

• Experity maintains a learning program foundation for the company that allows Team Members to explore their potential and achieve their career goals.

• Team Building

- We bring our Team Members together when we can to strengthen the team, build relationships, and have fun! We even have a family company picnic and a holiday party.

• Total Compensation

• Competitive pay, quarterly bonuses and a 401(k) retirement plan with an employer match to help you save for your future and ensure that you can retire with financial security.

Onsite: This position will be onsite Monday

• Friday at our Machesney Park office.

Job Type: Full time

Work Schedules: Monday

• Friday

• 7:30 am

• 4:00 pm

• 8:00 am

• 4:30 pm

• OT available after training if requirements are met

Responsibilities:

• Review charge entry SOP for new clients to determine if we need any additional information and obtaining if lacking.

• Create and maintain the Cheat sheet for each new client.

• Create and maintain the annual flu code cheat sheet and load in fee schedules as needed.

• Add ndc's to appropriate fee schedules when clients provide the NDC listing.

• Run, sort, interpret and review various audits as needed and provide feedback to teams, management, and clients regarding issues identified on the audits.

• Ability to identify issues such as, but not limited to, payer, claims, key performance indicators, client, EDI and payment issues.

• Communicate & coordinate with the off shore team regarding items related to the clients they are servicing for charge entry. Facilitate training sessions with those team members to provide feedback for areas of improvement.

• Applies payments and adjustments to patient accounts as appropriate.

• Complete charge entry for partial RCM clients as needed.

• Assist with maintaining PM setups to ensure accurate and timely submission of claims. This includes loading insurance carriers timely and accurately.

• Assist with training of new and existing staff.

• BETA testing and issue reporting/tracking.

• Cover for captain duties as needed.

• Maintain insurance set ups.

• Perform quality assurance on staff's work and provide feedback to management and employee about job performance.

• Review and complete month end tasks for all clients.

• Provide feedback to providers regarding documentation in medical records.

• Complete quality review of onshore and offshore team members and provide feedback as appropriate.

• Resolve unbilled messages report.

• Responsible for notifying management of any trends with issues for clients, timey review of charges on hold, review and coding of patient medical records and insurance demographics.

• Assist RCM team members with denial questions related to documentation.

• Review new client checklist for onboarding clients.

• Review, track, and discuss key performance indicators and productivity variances.

• Update and manage auto charge entry rules engine.

• Complete message queues for all clients.

• Communicate with billing teams on shared tasks to ensure they are done timely-messaging, FINS, Month end.

• Make updates to the fee schedules to add missing codes, zero out send out labs not to be billed, zero out DME items not to be billed, adding dummy codes to new clients, etc.

• Other duties as assigned.

Education and Experience:

• High school diploma or equivalent

Preferred:

• One year experience in customer service/physician office

• Knowledge of medical terminology

Every Team Member lives and breathes our Core Values:

• Team First

• Lift Others Up

• Share Openly

• Set and Crush Goals

• Delight the Client

Our urgent care solutions include:

• Electronic Medical Records (EMR): Software that healthcare providers use to input patient data, such as medical history, diagnoses, treatment plans, medications, and test results.

• Patient Engagement (PE): Software that shows patients the wait times at various clinics, allows patients to reserve a spot in line if there's a wait, and book the appointment.

• Practice Management (PM): Software that the clinic front desk staff uses to register the patient once they arrive for their appointment.

• Billing and Revenue Cycle Management (RCM): Software that manages coding, billing and payer contracts for clinics so they don't have to.

• Teleradiology: Board certified radiologist providing accurate and timely reads of results from X-rays, CT scans, MRIs, and ultrasounds, for our urgent care clients.

• Consulting: Consulting services for urgent care clinics to assist with opening, expanding and enhancing client's businesses

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