Responsible for billing, follow-up, and managing denials to timely collect on assigned accounts receivable.
This position communicates daily with team members and managers to meet prescribed deadlines.
This role examines contracts and learns payer contracts to understand reimbursement methodology and appropriately reconcile patient accounts.
This position resolves and resubmits rejected claims, processes daily and special reports, and reviews previous account documentation to determine necessary actions.
Additionally, this role performs outgoing and incoming calls with patients and insurance companies to obtain information for accurate billing and collections.
Works with insurance payers to ensure proper billing, collections, or denial management on patient accounts.
Examines contracts to ensure proper reimbursement, educates team members on inconsistencies, and documents any changes.
Works follow-up reports daily, maintaining established goals, and notifies the supervisor of issues preventing goal achievement.
Follows up on daily correspondence related to denials, underpayments, and billing to appropriately manage patient accounts.
Assists customer service with patient concerns and questions to ensure prompt and accurate resolution.
Produces written correspondence to payors and patients regarding claim status and requests for additional information.
Reviews previous account documentation to determine necessary actions to resolve assigned accounts.
Initiates next billing, follow-up, and collection steps, including contacting patients, insurers, or employers as appropriate.
Documents billing, denials, and collection steps taken, escalating to the supervisor or manager if necessary.
Processes administrative and medical appeals, refunds, reinstatements, and rejections of insurance claims.
Communicates consistently with team members to foster a collaborative atmosphere and engages with the supervisor or manager on educational opportunities.
Assists with training new staff, performs audits of work, and communicates progress to the appropriate supervisor.
Other duties as assigned.
Requirements
High School Grad or Equiv Required
3+ Work Experience Required
Ability to use discretion when discussing personnel/patient related issues that are confidential in nature.
Ability to be responsive to ever-changing matrix of hospital needs and act accordingly.
Working knowledge of the Revenue Cycle and the links between departments: Charge Capture, Consumer Access, PreAccess, HIM, Coding, and Patient Financial Services.
Self-motivator, quick thinker, communicates professionally and effectively in English, both verbally and in writing.
Typing skills equal to 20 words per minute.
Proficiency in performance of basic math functions.
Ability to communicate professionally and effectively in English, both verbally and in writing.
Proficiency in Microsoft office products such as Word and Excel.
Strong analytical and research skills.
Able to conduct assigned work in either a fully remote or hybrid work environment