Full-timeEstimated: $31,000 - $40,000 a year
- High School Diploma or GED
Full Job Description
Reviews the account files of patients for accuracy and completeness. Prepares billings for third party payor according to procedures and regulations. Responds to inquires of eligibility and status of claims. Identifies health and safety concerns and unsafe work practices within the workplace. Is involved in developing safe work practices and is held accountable for the day to day efforts of ensuring a safe workplace by following safe work practices.
Prepares and submits clean claims to third party payers either electronically or by paper in a timely fashion, to include identifying and correcting all errors in the claims scrubber or applicable payer system according to documentation and payer guidelines.
Works all remittance advices for discrepancies and submits a request for correction as needed.
Utilizes all available systems for verifying eligibility, claim history/status, and online corrections according to compliance guidelines.
Statuses claims by calling insurance companies or utilizing their websites if applicable.
Follows all regulations and guidelines set by Medicare, state programs, and any other insurance plan.
Identifies, reviews, and works any credit balances and/or refunds as assigned.
Responsible for maintaining patient confidentiality and handling of personal information.
Works closely with other departments as needed for charge corrections, coding, copying of records, insurance, patient and/or guarantor data.
Works all aged accounts as assigned to ensure maximum reimbursement for services provided.
Handles patient inquiries and answers questions from clerical staff, other departments, and insurance companies.
Required to note all accounts of action taken.
Check email regularly to ensure timely follow up with other departments, patients and/or other pertinent requests.
Keeps work area organized for more productive work processes.
High school diploma or equivalent. Minimum of one year experience preferred in a hospital, minimum of one year experience required in physician billing, medical or insurance setting. Preferred certification in coding. Must be able to work in a fast paced environment, demonstrate positivity, and be able to work well in a team atmosphere. Must have the ability to multitask and manage time effectively. Must have outstanding problem-solving and organizational skills.