Essential Functions:
Responsible for verification and interpretation of insurance benefits and establishing financial arrangements with guarantor/patient.
Estimate patient out-of-pocket and make financial arrangements with guarantor/patient. Post payment follow-up with claims.
Prepare and review all billing forms to ensure accuracy and completeness for claims submission to insurance carriers and back up for Medicare and Medicaid claims.
Process claims electronically or hard copy with 100% accuracy and mail claims to insurance carriers timely.
Enter documentation and adjustments through computer system to maintain a correct account balance.
Updated system information according to correspondence received and processed. Document any changes and submit to appropriate staff.
Review charge summaries on each patient bill that is produced and identify discrepancies wit 100% accuracy.
Consistently apply appropriate procedures to prevent accounts from becoming delinquent or remaining unbilled.
Initiate appropriate follow-up and collection calls.
Review remittance advice statements for payments and adjustments on a daily basis and initiate appropriate data entry for patient chargeĀ or account discrepancy on review.
Identify denial and pending reasons and investigate, resolve and initiate information to secure reimbursement.
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