Bills Insurance Companies for all hospital claims. Pursues all insurances until payment is made and performs other work associated with the billing process. Responsible for processing third party insurance remittance advices by posting payments and adjustments on accounts. Also, prepares claims for secondary insurance billing or self-pay balances on balances remaining.
- EDUCATION: High School Diploma required. Post high school courses in accounting, data processing and medical terminology preferred.
- EXPERIENCE: Two years experience with automated billing system either in a hospital and/or physician setting required. Experience with MHC’s registration and billing processes highly desirable.
- JOB KNOWLEDGE: Understanding and knowledge of Meditech B/AR module. Ability to make decisions without Supervisor approval when applicable.
PRIMARY JOB RESPONSIBILITIES
- Daily prepares and submits claims to third party insurance carriers. Monitors claims for missing information and checks for late charges/credits or erroneous charges.
- Secures needed medical documentation required or requested by insurances.
- Maintains assigned Accounts Receivable at an appropriate level consistent with industry standards.
- Follows up on denied claims in a timely manner.
- Daily processes rejections.
- Works with Medical Records staff on coding issues.
- Posts payments/adjustments from insurances.
- Submits secondary insurance claims when applicable.
- Keeps updated on all billing and reimbursement changes from insurance carriers.
- Handles patient phone calls and questions effectively and achieves resolution in a timely manner.
- Portrays a willingness to accept changes in workflow as a result of technological advancements.
- Maintains quality in all tasks assigned.
- Completes all tasks within specified deadlines.
- Must be able to work effectively with others.
24. Demonstrates knowledge of, and supports, hospital mission, vision, value statements, standards, policies and procedures, operating instructions, confidentiality standards, the code of ethical behavior, and the corporate compliance plan.