Tour 2 (9:00am – 5:00pm)
PURPOSE OF POSITION:
Under direct supervision, conduct investigations to take the necessary actions to bill and collect for services; verify, modify and code demographic and insurance data obtained from source documents, and accurately enter such data into computerized system(s) ensuring compliance with payer rules and regulations; perform billing and collection functions; complete and/or review paper and electronic claims for proper and timely submission to insurance carriers; follow up with insurance carriers, employers and/or patients for prompt payments; monitor and track denials and underpayments received from insurance carriers; complete non-clinical appeals when necessary; escalate accounts to supervisor in a timely manner in order to obtain maximization of a hospital’s or health care facility’s revenue.
AREAS OF RESPONSIBILITIES:
Patient Accounts, Managed Care, Billing, Denials, Audits, and Payment Reconciliation
SUMMARY OF DUTIES AND RESPONSIBILITIES:
The identification of essential functions below is not intended to be an exhaustive list of all duties that may be assigned to this position, nor does it restrict the duties which may be assigned to the position within the revenue cycle process.
- Ensure compliance with payer rules and regulations
- Perform routine follow-up on outstanding insurance balances
- Review and work appropriate accounts to maximize A/R reduction and minimize write-offs
- Review payer denials and underpayments and work to resolution
- Complete claims for review and processing by the Supervisor
- Interact with other departments to resolve outstanding payer balances
- Refer accounts requiring escalation to Supervisor in a timely manner
- Attend all necessary training sessions to effectively perform the day-to-day functions of the position
- Perform all other duties as assigned by the Patient Accounting Manager or Supervisor