RESPONSIBILITIES
1) Provide customer service both on the telephone and in the office for all patients and authorized representatives regarding patient accounts in accordance with practice protocol. Patient calls regarding accounts receivable should be returned within 2 business days to ensure maximum patient satisfaction.
2) Performs and demonstrates an understanding of insurance collections to include: payment in full, overpayment reviews and approvals, next action on correspondence.
3) Verifies patient coverage, benefits, deductibles, and co-payment requirements.
4) Monitor and assist in resolution of daily tasks assigned to department within practice management system.
5) Assist with Claims Center and Clearinghouse daily tasks.
6) Enters information necessary for insurance claims such as patient, insurance ID, diagnosis and treatment codes and modifiers, and provider information. Ensures claim information is complete and accurate.
7) Produce and submit claims to individual insurance companies via paper CMS-1500 form. For patients with coverage by more than one insurer, prepares and submits secondary claims upon processing by primary insurer, and tertiary when applicable.
8) Follow-up on outstanding insurance claims in accordance with practice protocol.
9) Assist with returned claims, correspondence, denials, account reconciliations.
10) Analyze, investigate, and resolve billing problems and denied/unpaid claims involving contact with patients, physicians, and insurance companies. Prepares appeal letters to insurance carrier when not in agreement with claim payment.
11) Post insurance payments into the practice management system.
12) Process refunds to insurance companies in accordance with practice protocol.
13) Periodically create insurance aging reports using the medical practice billing software.
14) Make proper adjustments as necessary to accounts.
15) Monitor reimbursement and limitations of managed care networks and insurance carriers to ensure reimbursement is consistent with contract rates.
16) Prepares daily close and deposits; responsible for petty cash.
17) Assist with training of staff on billing department protocols.
18) Works collaboratively with all other departments to ensure a positive patient experience.
19) Other duties, as assigned.
KNOWLEDGE, SKILLS, AND ABILITIES
EDUCATION/EXPERIENCE REQUIRED
Job Type: Full-time
Benefits:
Benefits:
An Equal Opportunity Employer
We do not discriminate based on race, color, religion, national origin, sex, age, disability, genetic information, or any other status protected by law or regulation. It is our intention that all qualified applicants are given equal opportunity and that selection decisions be based on job-related factors.
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