Description
- Prepares and submits clean claims to third party payers either electronically or by paper in a timely fashion, to include identifying and correcting all errors in the claims scrubber or applicable payer system according to documentation and payer guidelines.
- Works all remittance advices for discrepancies and submits a request for correction as needed.
- Utilizes all available systems for verifying eligibility, claim history/status, and online corrections according to compliance guidelines.
- Statuses claims by calling insurance companies or utilizing their websites if applicable.
- Follows all regulations and guidelines set by Medicare, state programs, and any other insurance plans.
- Identifies, reviews, and works any credit balances and/or refunds as assigned in Meditech.
- Works all assigned worklists in Meditech to include tasks, credits, account checks, and combine accounts.
- Responsible for maintaining patient confidentiality and handling of personal information.
- Works closely with other departments as needed for charge corrections, coding, copying of records, insurance, patient and/or guarantor data.
- Works all aged accounts as assigned to ensure maximum reimbursement for services provided.
- Handles patient inquiries in addition to answer questions from clerical staff, other departments, and insurance companies.
- Required to note all accounts of action taken.
- Check email regularly to ensure timely follow up with other departments, patients and/or other pertinent requests.
- Keeps work area organized for more productive work processes.
- Adheres to quality expectations and productivity tracking measures.
RequirementsHigh school diploma or equivalent. Minimum of one-year billing experience preferred in a hospital, physician, medical or insurance setting. Must be able to work in a fast-paced environment, demonstrate positivity, and be able to work well in a team atmosphere. Must have the ability to multitask and manage time effectively. Must have outstanding problem-solving and organizational skills.