Business Operations Representative

GENERAL DESCRIPTION:

This position is located at the Absentee Shawnee Little Axe Health Center in Norman, Oklahoma within the Business Operations department and would serve all functions of the AST Health System. The AST Health System is an ambulatory health system that currently serves patients with Medicaid (Indian and Non-Indian), Absentee Shawnee Tribal Citizens, and Absentee Shawnee Tribal employees and other Native Americans.

RESPONSIBILITIES:

• **Medical Billing**

• Prepares and submits clean claims to various insurance companies either electronically or by paper.

• Answers questions from patients, clerical staff and insurance companies.

• Reviews accounts and makes recommendations to the Business Operations Manager.

• Performs various collection actions including correcting and resubmitting claims to third party payers.

• Participates in educational activities and attends staff meetings.

• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.

• **Data Entry**

• Prioritizes and batches material for data entry.

• Completes information analysis for procedures and reports.

• Inputs information from a variety of sources into Prometheus and Lytec databases.

• Serves as the primary contact for all data entry.

• Other duties as assigned by direct supervisor.

QUALIFICATIONS:

• Associates degree or equivalent with 2-4 years of experience in medical records and/or medical data entry.

• Three years’ experience in a fast paced medical office setting is desirable.

• Certification in medical reimbursement specialist.

• Knowledge of the third party claims generation and accounts receivable process.

• Knowledge of business office procedures and medical billing practices.

• Comprehensive knowledge of Medicare/Medicaid and Social Security benefits rules and regulations.

• Knowledge of private insurance payments systems.

• Analytical or administrative experience in the Business Office field interpreting and applying Business Office principles, concepts, regulations and practices.

• Capable of high volume data entry.

• Ability to communicate effectively orally and in writing; ability to relate well with co-workers and the general public.

• Ability to adjust to changing conditions.

• Must be computer literate required (Windows operating systems – Microsoft Word, Excel).