Protects hospital from losses by ensuring third party insurance claims are billed in accordance with federal, state and local regulatory requirements and statutes. Resolves patient and insurance inquiries. Follows up with third party payors to ensure reimbursement is received within 60 days.
Essential Job Duties:
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Actively adheres to regulatory and governmental agency requirements regarding billing and reimbursement.
Prepares and bills patients’ insurance, including interim billing and late charges. Paper claims are to be reviewed for accuracy and billed within two business days.
Resubmits and/or contacts insurance carriers to follow up on previously billed accounts. Accurately rebills when appropriate.
Performs necessary functions in Work-queues and / or aged trial balance taking steps to resolve obstacles to timely payment.
Advises team leader of any errors or issues that may be contributing to slow payment or non-payment of claims. Ensures actions are documented in the Meditech B/AR comments routine or EPIC account notes.
Answers and resolves telephone inquiries and correspondence in professional, courteous manner.
Attends daily huddles, department meetings and in-services.
Follows Standard work daily
Prepares documentation and submits for scanning daily as needed.
Utilizes appropriate website, provider portals and other media as needed for claims resolution.
Numerical skills and previous Billing/Accounts receivable systems experience required.
Excellent verbal and written communication skills.
One year experience in hospital billing in automated setting.
Working Conditions, Equipment, Physical Demands:
There is a reasonable expectation that employees in this position will not be exposed to blood-borne pathogens.
Physical Demands –
Light work. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work.
The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act.
The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.