- Knowledge of Third Party Payer billing requirements and regulations
- Demonstrated experience of Medicare and Medi-Cal billing requirements including knowledge of UB-04 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 the UB-04, in MCCS claims production tables and special requirements associated with use of specific codes.
- Detailed knowledge of billing process;
- Ability to design and assist with implementing new billing system processes including: analyzing needs, creating project specifications, implementation and post-implementation evaluation.
- Ability to function as a liaison.
- Ability to write concise, logical and grammatically correct English as used in documents such as technical reports, specifications, and technical documentation, 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 analysis and documentation of functional requirements.
- Ability to assure adequate system testing and installation plans prior to any production use. Ability to assure adequate system controls on all new modified software.
- Ability to translate user needs into requirements documents.
- 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 evaluate issues and requests and recommend priorities (based on input from programmers and in consultation with users).
- Knowledge or Microsoft Software Applications, including: Word, Excel, Access, MS Mail, and Internet Explorer.
- Demonstrated skill in consistently completing heavy workloads within established time frames.
- 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. 19.
- Ability to maintain confidentiality of patient information at all times
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