Description
Summary:
Review and resolve outstanding A/R accounts to ensure activities regarding patient accounts are reviewed and resolved in a timely and thorough manner, ultimately resulting in full payment on the account. This description is not intended to be a complete list of duties.
Responsibilities:
- Demonstrates knowledge and skills necessary to provide services based on the physical, psychosocial, educational, safety, and other related criteria appropriate population in his/her assigned area
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Maintains required core competencies.
- Complies with set Policies and Procedures (i.e. name tag, dress code, parking, smoking, etc.)
- Reviews payer EOB’s but not limited to payment accuracy, patient liability, and appeal grievances.
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Work 60 accounts daily
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Files appeal on denied claims and/or forwards to the Nurse Auditor for review
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Process incoming mail correspondence from payers within 5 business days.
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Follow up with the insurance companies by phone and or web for the status of outstanding claims.
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Follow up with all insurance companies within 30 days of billing if there is no payment on the account.
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Enter detailed notes explaining account activity in the Patient Accounts system
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Respond to patient inquiries regarding the status of the patient’s insurance within 2 business days.
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Forward patient complaints regarding care to your supervisor for entry into the appropriate resolution pathway.
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Accept payments over the phone.
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Research late charges to determine the cause; inform your supervisor if they are a regular occurrence.
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Report payer trends to Supervisor and Director of Patient Financial Services· Maintain courtesy and respect at all times when working with internal and external customers
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Performs other duties as assigned
Requirements:
Education
- High School diploma or equivalent.
Experience
- Prefer two (2) years of hospital or physician practice billing and/or collections experience.
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Able to work with volume accounts for resolution.
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Working knowledge of computers and calculators desired.
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Possess the ability to work with internal and external customers
Licenses, Certifications or Registrations
- Current American Heart – Basic Life Support (BLS)card.
Work Schedule:
Varies
Work Type:
Full Time
