Medical Administrative Assistant

McAllen, Texas
Health & Social Care, Practitioner & Technician (Healthcare Practitioners and Technical Occupations)
Job Type
Temp to Perm
Working Hours
8:00 AM - 5:00 PM
US$ 9.00 - US$ 13.00 per hour
Ref. Number
Loredo,Maria, Spherion
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Job Description

This position will run our Front Desk and determine insurance eligibility, financial status and eligibility for registration by reviewing insurance information via phone or on line verification, calling third party payers to obtain insurance benefits which include the effective dates of coverage, billing address, pre-existing condition clauses, in and out of network benefits and maximum coverage. This position is responsible for determining and collecting the patients' personal financial obligations prior to the procedure.

??? Promotes the facility mission, vision and values by effectively communicating them to others. Considers mission, vision and values in developing services, standards and practices
??? Appropriately monitor and verify benefits for all accounts on the daily office visit schedule, in office procedure and pre-admission roster for the next day???s services.
??? Forwards a completed copy of schedule with applicable patient benefits to front desk staff for collection of applicable deductible and co-pay amounts.
??? Confirms billing address, pre-existing conditions, in and out of network benefits and maximum coverage.
??? Reviews and confirms patient's financial information by obtaining the insurance carrier information, benefit information, policy number, group name, group number, and the effective date of coverage.

Working hours: 8:00 AM - 5:00 PM

- Ability to reference ICD-9-CM/ ICD-10-CM, CPT from doctor's order to insurance carrier for eligibility and coverage of procedure
- Ability to determine timely filing deadline for all insurance carriers.
- Ability to review managed care contracts in order to determine that all carrier requirements have been met for procedures or visits.
- Reviews and confirms patient's deductibles, co-pays, and co-insurance with insurance carrier
- Determines and collects patient personal financial obligations or negotiates a payment plan prior to surgery
- Ability to identify the appropriate coordination of benefits for insurance carrier.
- Utilizes phone or on-line verification systems, i.e. TMHP, Availity, Data Link, internal system, etc., for insurance eligibility and benefits.
- Ensures referral/pre-authorization/pre-certification requirements have been met.
- Obtains pre-certification approval as needed.
- Obtains date of injury, compensable bodily injury, adjuster's name, onset of illness and claim number, for worker's compensation claims, as needed.
- Reviews physician order for appropriate patient status (Inpatient/Outpatient) before verifying coverage for procedure.
- Accurately performs basic mathematical calculations, balance and reconcile figures, punctuate properly and spell correctly.
- Document clearly and concisely all patient benefit information on accounts through the computer system
- Demonstrates proficiency of personal computers and Microsoft Office applications and other software as required.
- Has appropriate follow up and contact with hospital or patient if necessary.
- When working at the reception desk, checking patients both in and out of the practice properly documenting registration in the computer, as needed.
- Ensures patient confidentiality requirements are met in accordance with HIPAA/PHI policies and procedures.

High School

0-1 years

??? High School Diploma/ GED is preferred

??? Good understanding of insurance benefits and medical terminology
??? Knowledge of Microsoft Office suite, working knowledge of Excel required
??? Excellent customer service and interpersonal skills
??? Good written and verbal communication skills are required.
??? Ability to read, write and speak English required
??? Ability to communicate clearly and concisely with all levels of management
??? Previous healthcare and ENT billing experience (> 5 yrs.) is required, physician or hospital experience preferred. Certified ENT coder/ Biller preferred.
??? Communicates clearly and concisely and is able to work effectively with other employees, patients and external parties
??? Demonstrates proficiency in Microsoft Office applications, be able to type at least 35 WPM, and good working knowledge of Excel is required.
??? Medical Terminology, ICD Codes, CPT Codes, HCPCS codes, and Modifier knowledge preferred.
??? Able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly and spell correctly.
??? Requires reasoning ability, good independent judgment and organizational skills.
??? Requires organized person able to work with frequent interruptions.
??? Must project a professional image.

As above

Spherion has helped thousands of people just like you find work happiness! Our experienced staff will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temp-to-perm or direct hire opportunities, no one works harder for you than Spherion. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.

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