Description
- Demonstrates knowledge and skills necessary to provide services based on the physical, psychosocial, educational, safety, and other related criteria appropriate population in his/her assigned area
- Maintains required core competencies.
- Complies with set Policies and Procedures (i. e. name tag, dress code, parking, smoking, etc.)
- Submits all clean claims to the appropriate insurance payer the same day as the claim is received with the exception of weekends.
- Reviews payer EOB's but not limited to payment accuracy, patient liability, and appeal grievances if applicable.
- Files appeals on denied claims and/or forwards to the Lead Patient Account Analyst for review if applicable
- Maintain better than an 80% clean claim average.
- Attach but not limited to the medical records, time records, and itemized bill to the claim when applicable
- Process incoming mail correspondence from the payers within 5 business days
- Work assigned billing reports within 2 business days
- Follow up with the insurance companies by phone and or web for the status of outstanding claims if applicable
- Respond to patient inquiries regarding the status of the patient's insurance within 2 business days
- Submit newborn notifications to income support if applicable
- Review/resolve the accounts on the Missing Slips Report daily (accounts that are on hold and haven't been processed).
- Enter detailed notes explaining account activity in Athena
- Take payments over the phone.
- Print UB and 1500 hardcopy claims when required by the payer
- Bill secondary claims before the timely filing deadline
- Research late charges to determine the cause; inform your supervisor if they are a regular occurrence.
- Handle incoming correspondence and inquiries on accounts.
- Report trends/issues to Supervisor
- Follow up with all insurance companies within 30 days of billing if there is no payment on the account if applicable
- Forward patient complaints regarding care to your supervisor for entry into the appropriate resolution pathway
- Performs other duties as assigned
Requirements
Education
Required:
High School
Licenses & Certifications
Required:
C-Heartsaver