- Knowledge of Healthcare and Third Party Payer billing requirements and regulations.
- Demonstrated experience with Medicare and Medi-Cal billing requirements including knowledge of UB-92 requirements for line-item outpatient and inpatient hospital billing.
- Detailed knowledge of revenue codes, CPT codes and ICD-9 codes including use as grouper on UB-92, in MCCS claims production, tables and special requirements associated with use of specific codes.
- Detailed knowledge of the billing process: understanding of trail from charge master to charge document through date preparation, to billing tables and profiles to claims production and including an understanding of inter-relationship between CPT-4 and UB-92 revenue codes.
- Ability to design and assist with implementing new billing system processes, including: analyzing needs, creating project specifications, developing goals and objectives, implementation and evaluation.
- Ability to function as a liaison. Skill in analyzing financial data to recognize trends and too make projections.
- Ability to write concise, logical and grammatically correct English as used in documents such as technical reports, specifications, and technical documentations, instructions, operating procedures, reports, letters and project plans.
- Skill in reading and interpreting instructions from third-parties, recognizing discrepancies, instruction or impact on areas beyond Patient Business Services such as MCCS or Admission and Registration.
- Demonstrated knowledge of and skill in detailed technical analysis , documentation of requirements and working knowledge of database structures.
- Ability to translate user needs into technical actions.
- Ability to coordinate a task force made up of users, user management analysts and programmers to negotiate a resolution to a problem in an efficient and timely manner.
- Demonstrated interpersonal skills to work in a group environment, establishing and maintaining a cooperative working relationship with users, staff, and other department personnel.
- Ability to assign priorities of tasks in conjunction with programmers and in consultation with users.
- Expert skill and knowledge using Microsoft Software Applications, including: Word, Excel, Access, MS Mail, Internet Explorer.
- Ability to assess, maintain, and monitor confidentiality of sensitive patient billing and clinical information.
- Demonstrated ability to work independently and to appropriately prioritize work. Ability to work overtime as required.
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