JOB SUMMARY: Executes actions which promote timely, accurate and effective billing, follow-up, problem resolution and positive customer service. Ensures all necessary information and proper documentation are provided. Monitors delinquent accounts in order to receive overdue payments and return accounts to current payment status. Responds to customer inquiries regarding account status, resolves discrepancies and prepares adjustments as necessary.
Work Experience: Minimum of 3+ years of billing experience in Meditech LSS and clinic patient management system.
Prepares Account Billings And Submits Accurate Claims In a Timely Manner
- Consistently and accurately interprets insurance requirements and regulations.
- Obtains necessary information from appropriate Clinic or Hospital and incorporates into billing process (i.e. ICD-9 codes, Principal Diagnosis, TARS, CPT-4 codes, HCPCS, etc.)
- Verifies that charges are accurate and complete 100% of the time.
- Review eligibility and confirm that benefits have been properly verified before submitting claims.
- Ensures that bills are sent out for payment within 24 hours of finalization.
- Verify these functions have been completed prior to processing self-pay accounts.
- Responsible for self-pay and insurance accounts/ balances for assigned payers.
- Candidate will be responsible for reviewing accounts, potentially making outbound calls and sending letters to patients and third-party companies to collect on delinquent medical accounts.
- Review account information to determine why claims weren't paid and research denied claims.
- Receive, open, and make contact calls on correspondence received through mail.
- Verifies insurance payments and write-offs are correct before billing patient.
- Resolves billing problems in a timely manner.
- Set up payment arrangements with patients.
- Maintain detailed records by filing of transactions and documents while entering detailed comments into the computer so that a complete and accurate audit trail is maintained.
- Document all work and calls performed on productivity worksheets.
- Ability to complete the following tasks within department standards and established timeframes:
- Billing of claims
- Verification process
- Claim check rejection list
- Rebilling of accounts
- Process remittance advice for denials/suspends
- Lead all collection efforts and follow-up for assigned inventory