Position Summary: Supports the financial position through accurate and timely billing of claims and collection of monies owed to the hospital. Bill appropriate insurance companies. Knowledgeable and adhere HIPAA guidelines. Assist patients with financial arrangements, review credit history, and gathers patient/resident information. Contact patient and third party collect payments, reviews patient charts for accuracy and verifies insurance, prepares patient statements as necessary
Review claims for accuracy and completeness.
Contact patients and third-party payers to collect payments and resolve outstanding account balances.
Follow up on billed accounts to Medicare, Medicaid, and Commercial payers to resolve claim rejections for eligibility, coverage, and other issues.
Prepares and send patient self-pay statements.
Review billed claims for accuracy and completeness.
May receive and post patient payments made in person, over the phone, or electronically.
Be knowledgeable of and adhere to HIPAA guidelines.
Has access to Medical Records of cases to which they are assigned work. Use of PHI is limited to assigned tasks.
All other duties as assigned
Education: High School Diploma/GED required. College degree preferred.
Experience: Prior work experience in the healthcare field, practically in hospital business office or physician offices with knowledge of collections.
Licensure/Certification: CPR certification and CPI certifications preferred as needed
HIPAA: Has access to all PHI necessary to perform job functions and assuring compliance with standards of care.
Other: Must have knowledge of Medicare billing guidelines as well as UB-04 and CMS 1500 billing practices for Commercial Insurances and Medicaid. Computer skills including proficiency in Windows MS Office – Excel, Word and Outlook. Customer service skills with excellent verbal and written communication skills including phone etiquette. Detail oriented, following through on tasks, problem-solving, troubleshooting and multi-tasking. Self-starter, demonstrates initiative and flexibility in a fast-paced environment. Must be a team player and conduct self in a professional manner.
Ability to stoop, kneel, crouch, reach, push, pull, and lift 50 pounds; ability to finger (e.g. pick, pinch, type) and grasp; ability to express and exchange ideas by spoken word in an accurate, audible, and occasionally quick manner. Ability to perceive sound with no less than a 40 db loss @ Hz, 1000 Hz, and 2000 Hz with or without correction and to make fine discriminations in sound; ability to perform substantially repetitive motions of the wrist, hands, and fingers; ability to perform substantially sedentary to light work, exerting between 10 to 20 pounds of force; ability to lift or move objects. Ability to accept instruction. Ability to get along with others. The worker is subject to some temperature changes but is largely protected from changing weather conditions.