Skilled Billing Representative well-versed in billing practices, account monitoring and collections. Builds rapport with customers, solving diverse problems and obtain payments.
• Reviews patient eligibility utilizing practice management function or payer websites to determine correct payer to be billed for specific dates of service.
• Prepares claim data according to department and payer regulations in order to produce a “clean” claim.
• Prepares, reviews and transmits claims timely to payers, works EDI rejections.
• Posts charges, payments and denials in practice management system accurately.
• Works denials and prepares appeals, resubmits claims and performs compliant actions to resolve open accounts receivable. Reports unusual trends to supervisor.
• Works with payer representative to research and resolve denials issues and obtain payer policy knowledge as necessary.
• Utilizes insurance and practice management online systems to complete all required tasks such as eligibility, claim status and claim correction.
• Processes insurance and patient refunds as necessary.
• Answers patient and department calls. Assist in telephone inquiries regarding patient statements. Establish payment arrangements when appropriate.
• Scans/files all relevant documentation.
• Reconcile all batch totals at day end to ensure accuracy of totals posted and transactions on charge capture. Identify and correct any discrepancies prior to opening any future batch.
• Maintain the utmost patient confidentiality, billing and HIPPA compliance at all times when accessing any data in the Practice Management and or EMR systems.
• Other duties, assignments or projects assigned by the Supervisor or Patient Accounts Director within the scope of the position.
• Become knowledgeable about the GLFHC Improvement plan and the model for improvement endorsed by the organization.
• On a regular basis participate in ongoing quality improvement activities related to individual, team, and organizational performance improvement.
• Travel between sites may be required.
• Performs all and any additional duties as assigned.