Submits and collects all primary and secondary insurance for Federal, State, and Managed Care payers. Collects all Self Pay and Self Pay After Insurance accounts and identifies alternative Self Pay payment options. Determines patient eligibility for State and internal financial assistance programs. Resolves patient inquiries regarding patient accounts. Processes cash applications to patient accounts. Analyzes insurance payments to patient accounts in accordance with Managed Care contract terms.
High school graduate or equivalent diploma required.
One to five years of experience in medical billing or collections or customer service or accounting.
Ability to conceptualize the flow of information through systems in order to trouble shoot and problemsolve to eliminate and/or prevent processing delays
Ability to perform multiple tasks in a production-oriented environment
Ability to work with various internal contacts in a multi-facility environment and external contacts,including governmental agencies, employers, patients, insurance companies, vendors, etc.
Knowledge of Managed Care contracts and negotiations and contractual allowance
Working knowledge of third party payer requirements and payment patterns
Knowledge of collection laws
Working knowledge of patient registration and patient accounting for healthcare providers
Working knowledge of various billing formats, including UB92 and HCFA 1500, and financial documents,including W-2, self employment records, unemployment and disability records
Must possess excellent mathematical aptitude, attention to detail, and effective organizational, written and verbal communication skills
Knowledge of medical terminology, ICD-9 and CPT-4 coding
Experience operating a personal computer and 10-key calculator
Knowledge of Microsoft Office preferred and ability to type 45 wpm
Demonstrate tact, respect, confidentiality, maturity, and professional behavior
Ability to work in a team-oriented atmosphere, exercise good judgement with minimum supervision
Medicare experience preferred.