IDENTIFICATION Department Position Title Northwest Territories Health Medical Billing Clerk and Social Services Authority Position Number Community Division/Region 48-5790 Fort Simpson Financial Services PURPOSE OF THE POSITION The Medical Billing Clerk is responsible to for providing ICORE medical billing services to ensure physician shadow billing is completed in a timely and accurate manner in accordance with the acts, regulation, policies and procedures of the Northwest Territories Health and Social Services Authority (NTHSSA) and Government of Northwest Territories (GNWT). SCOPE The Medical Billing Clerk is located in Fort Simpson and reports to the Manager, Accounts Receivable. This position is responsible for entering all shadow billing into the ICORE program to ensure billing and collection occurs in a timely and accurate manner. The medical billing services are covered under the Territorial Health insured Services (THIS) Act and the Northwest Territories Health and Social Services Authority (NTHSSA) policies and procedures. The NTHSSA is responsible for the effective delivery of health and social services in the Deh cho Region. The geographical area of responsibility comprises the Deh cho Region, with residents living in nine communities: Fort Liard, Fort Providence, Fort Simpson, Hay River Reserve, Jean Marie River, Kakisa Lake, Nahanni Butte, Trout Lake and Wrigley. RESPONSIBILITIES 1. Maintains the Physician shadow billings through the ICORE program, ensuring accuracy, completeness and timeliness of processing. • Registers the Physicians through the Department of Health and Social Services and the Government of the Northwest Territories in order to process physician billings through the ICORE program; • Assigns physician fee code to Out Patient forms (OPD); January 14, 2020 GNWT Job Description Page 1 of 4 • Data enters all relevant data including appropriate physician code and ICD code into ICORE; • Follow-up on weekly submissions to ensure billings are accepted; • Correction of data as required; • Receives detailed pay-run reports from the Department of Health in Inuvik outlining the amounts paid based on data entry; • Reconciles claims submitted to claims paid and deals with discrepancies. 2. Assists with preparing Outpatient Service Reports (OSR) to THIS for both Territorial and third party billings to ensure that NTHSSA records correct revenue and statistical information on facility usage. Works with Medical Billing Administrator and admissions staff to address errors made for patient registration to ensure the registration applies insurance coverage and that the correct insurance coverage is selected to ensure complete and accurate billing for THIS claims. 3. Assists in assigning physician fee codes and physician fees on OSR to ensure proper payment of claim submissions. Reviews OSR and ensure and/or assign physician procedure fee codes based on the insured Services Tariff in conjunction with the Medical Billing Administrator. Ensures and/or assigns diagnosis codes using correct ltd. 9 coding. Adds any additional procedures or services not recorded on OSR; Reviews Clinic Day Sheets to ensure and/or assign accurate physician procedure fee codes based on the insured Services Tariff. Ensures and/or assigns diagnosis codes using correct ICD 9 coding. Adds any additional procedures or services not recorded on Clinic Day Sheets; Enters all physician data into Medicare Module of NHIMS. WORKING CONDITIONS Physical Demands No unusual demands. Environmental Conditions No unusual demands. Sensory Demands Requires attention to detail and high levels of concentration. Mental Demands No unusual demands. January 14, 2020 GNWT Job Description Page 2 of 4 KNOWLEDGE, SKILLS AND ABILITIES Knowledge of health terminology and file management. Knowledge of ICORE program in order to process physician billings efficiently and accurately. Computer skills including keyboarding, Microsoft Word Excel and internet Explorer. Ability to pay attention to details to ensure accurate data input. Ability to communicate clearly and concisely verbally and in writing in English. Good organizational and interpersonal skills. Self-starter with ability to work independently with minimal supervision. Ability to set priorities and organize daily work load. Ability to work effectively in a cross-cultural environment Typically, the above qualifications would be attained by: Compeletion of a High School Diploma combined with two years of related experience in a health environment. Medical terminology or medical billing experience is required. Equivalent combinations of educational qualifications and experience will be considered on individual basis. ADDITIONAL REQUIREMENTS Position Security (check one) ☐ No criminal records check required ☐ Position of Trust – criminal records check required ☐ Highly sensitive position – requires verification of identity and a criminal records check French language (check one if applicable) ☐ French required (must identify required level below) Level required for this Designated Position is: ORAL EXPRESSION AND COMPREHENSION Basic (B) ☐ Intermediate (I) ☐ Advanced (A) ☐ READING COMPREHENSION: Basic (B) ☐ Intermediate (I) ☐ Advanced (A) ☐ WRITING SKILLS: Basic (B) ☐ Intermediate (I) ☐ Advanced (A) ☐ ☐ French preferred Indigenous language: Select language ☐ Required ☐ Preferred January 14, 2020 GNWT Job Description Page 3 of 4 .