Location: South Lyon,MI, USA
GENERAL SUMMARY
* Department: Primary Care
* Schedule: 8-hour day shift, Monday-Friday
* Location: South Lyon, MI
Determines and verifies insurance coverage and coordination of benefits from all sources for assigned area. Ensures proper adequate and timely billing to ensure prompt payment.
* Confirms insurance coverage. Determines necessity for pre-authorization and obtains authorization for scheduled procedures.
* Determines financial responsibility for services to be provided. Notifies patients and/or practitioners of any services requested and/or referred that are not authorized by insurance.
* Communicates with patients and practitioners regarding financial responsibility and insurance coverage issues.
* Maintains detailed documentation in the patient account record of all billing activities. Maintains documentation of claims processed as part of the daily claims reconciliation process.
* Prepares and completes claims for commercial insurance companies, third party organizations and/or government or self payers.
* Researches, analyzes and reconciles Medicare/Medicaid billing and reimbursement practices.
* Maintains detailed documentation in the patient account record of all billing activities.
* Maintains documentation of claims processed as part of the daily claims reconciliation process.
* Consults with appropriate parties to resolve unbilled claims. Reviews recent accounts for proper billing practices and reimbursement.
EDUCATION/EXPERIENCE REQUIRED
* High School diploma equivalency OR 1 year of applicable cumulative job specific experience required. - Note: Required professional licensure/certification can be used in lieu of education or experience, if applicable
Additional Information
* Organization: Henry Ford Ascension Medical Group MI
* Department: PMHC S Lyon
* Shift: Day Job
* Union Code: Not Applicable