PRIMARY FUNCTIONย
Posts payments and makes necessary adjustments via payment management systems as well asย identifiesย andย processesย the issuance of patient or insurance refunds.ย
ESSENTIAL DUTIES AND RESPONSIBILITIESย
This list may not includeย allย the duties that may be assigned.ย
Ensures payments or adjustments are postedย in accordance withย EOBโs and patient checks.ย Reviewsย and correct any errors until payments are balanced.ย ย
Post insurance payments and patient refunds from EOB or ERA accurately againstย appropriate line-itemย services andย entersย adjustments asย indicatedย whenย requiredย according to contract.ย ย
Assesses,ย identifiesย payment/denial trends via payment managementย systemsย and communicates to Team Leader and Managerย ย ย ย
Monitor and report any underpayment orย overpayment.ย ย ย
Research andย resolvesย any unapplied payments.ย ย
Performs other duties as assigned.ย
QUALIFICATIONSย
EDUCATION:ย ย
EXPERIENCE:ย ย
KNOWLEDGE,ย SKILLS,ย AND ABILITIESย
Knowledge of Medical billing and collection protocol, all types of insurance (HMO, PPO, POS, Medicaid etc.).ย ย ย
TYPICAL WORKING CONDITIONSย
ย
OTHER PHYSICAL REQUIREMENTSย
PERFORMANCE REQUIREMENTSย
Adhere to all organizational information security policies and protect all sensitive information including but not limited to ePHI andย PHIย (Protected Health Information)ย inย accordance withย organizational policy, Federal, State, and local regulations.ย
The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills,ย effortsย or working conditions associated with the job. It is intended to beย an accurateย reflection of the general nature ofย levelย of the job.