USA
Division/ Department: Billing
Oversees and/or performs all tasks related to medical billing for specific clients. Coordinates workflow and communication between the client and Pettigrew. Monitors offshore resources for productivity and quality assurance.
- Addresses all new work AR within 3 days of receipt on average
- Works Clearinghouse rejections daily
- Works with WSI or WSP staff and management to maintain Days in AR at 45 days or less and that 90+ aging is 15% or less of total AR
- Reviews and resolves aged AR; (objective is to have no more than 5% in any bucket over 91 days); Provide reasoning for any buckets above this percentage
- Applies appropriate appeals process where needed
- Resolves denied claims timely; minimize TLE's; works with carriers on claim resolutions
- Ensures appeals process is being followed according to Pettigrew Policy
- Assists with EOM Process as needed.
- Communicates with clients and their staff on a daily basis to resolve issues or errors.
- Communicate to management any negative trends; if applicable
- Ensures strict confidentiality of patient and financial records to comply with PHI, ePHI and HIPAA
- Where applicable: releases claims daily and additionally when new providers are approved by carriers. For MicroMD clients, bills claim no less than every two days.
- Where applicable: Monitors eBridge to ensure work is being completed within 3 days of receipt.
- Manages credit balances and works with clients to refund patients.
- Review, acceptance, and understanding of our workplace culture statement.
- The responsibilities listed in this job description are general descriptions of work assigned, duties and responsibilities may not be limited to just these responsibilities.
- Knowledge of Microsoft Office, Outlook, Google Suites, Data Entry skills; knowledge of paperless processes
- Ability to interact and communicate with people over the telephone, often in stressful situations
- Ability to communicate effectively, both orally and in writing
- Ability to gather data, compile information, and prepare reports
- Ability to use independent judgment and to manage and impart confidential information
- Records maintenance skills; both manual and scanned documents
- Knowledge of medical insurance claims procedures and documentation
- GED or high school diploma required; associate’s or bachelor’s degree preferred
- at least 3-5 years of business experience with an emphasis on the medical field; banking/financial institution experience a plus
