Department: Appalachian Institute for Health and Wellness – 273600
Minimum Qualifications
Graduation from high school and minimum of two years of related office experience with billing and credentialing; or an equivalent combination of education and experience.
Diplomas or degrees must be received from appropriately accredited institutions.
License/Certification Required
Essential Job Functions
- To execute all billing and credentialing for all AppWell clinic facilities.
- Claims Submission: Prepare, review, and transmit claims to insurance companies (commercial and government) for reimbursement.
- Payment posting: Post all payments received via mail, ACHs and or Virtual payments. Front desk staff will post all in-person payments.
- Revenue Cycle Management: Monitor claim status, follow up on unpaid claims, and appeal denied claims to ensure timely payment.
- Patient Billing: Calculate patient responsibility, send patient statements, and handle inquiries about bills.
- Compliance: Adhere to HIPAA regulations to maintain patient confidentiality and comply with all legal/payer requirements.
- Provide front desk back up support to the LLHS Clinic Front Desk as needed.
- Be available to train student interns, graduate assistants, and student employees as appropriate. Serve as a mentor modeling professional behavior.
- Execute Insurance provider enrollment processes and set up.
- Execute Initial set up and maintenance of credentialing for all affiliated providers.
- Update and maintain all CAQH Provider Profiles.
- Proper use and assignment of billing codes.
- Knowledge of HIPAA regulations.
- Stay up to date on appropriate billing codes and procedures.
- Balance end of day according to clinic policies and procedures. Track payments from all sources including Touchnet, Clover, Zelis, Availity, WayStar, (and others) as well as Student Accounts.
- Obtain prior authorizations as needed for allied health provider services.
Knowledge, Skills, & Abilities Required for this Position
Preferred Qualifications
Coding Expertise: Proficiency in ICD-10-CM, CPT, and HCPCS Level II coding systems.
Technical Proficiency: Familiarity with Electronic Health Records (EHR) and medical billing software.
Attention to Detail: Ability to spot inaccuracies in medical records and ensure precision in code application.
Communication: Strong verbal and written skills for interacting with providers and patients regarding billing.
Medical Knowledge: Understanding of medical terminology, anatomy, and physiology.
Work Schedule/Hours: Monday-Friday 8:00am-5:00pm
Anticipated Hiring Range:
Closing Date:
To apply, visit https://appstate.peopleadmin.com/postings/54080
Appalachian State University is an Affirmative Action/Equal Opportunity Employer. The University does not discriminate in access to its educational programs and activities, or with respect to hiring or the terms and conditions of employment, on the basis of race, color, national origin, religion, sex, gender identity and expression, political affiliation, age, disability, veteran status, genetic information or sexual orientation.
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