Location: Wilmington,NC, USA
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 and 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 timely.
* Enter documentation and adjustments through computer system to maintain a correct account balance.
* Update 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 with 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 charge or account discrepancy on review.
* Identify denial and pending reasons and investigate, resolve and initiate information to secure reimbursement.
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
* High school diploma or equivalent required.
* Must have at least 3 years' experience in related field.
* Must have extensive knowledge and understanding of Commercial Insurance and Medicare/Medicaid.