Provide quality, timely, courteous service, and optimum maintenance of patient accounts, including dissemination of information, billing services, follow-up, and collection of accounts receivable, bad debt, governmental, and contract compliance issues/guidelines

MINIMUM EXPERIENCE: 2 years of experience in hospital business office, insurance claims processing, physician office billing and/or hospital admitting and PC/CRT

PREFERRED EXPERIENCE: 3 years recent in hospital business office. Basic medical terminology; working knowledge of third-party payors, federal, state, and local billing regulations; and bilingual (English and Spanish)

Shift: Days

Hours: 8am to 5pm

Required Skills

General Functions:

· Demonstrates required skills for communication with various health insurance providers

· Possesses moderate billing knowledge, with the ability to perform remittance review and analysis

· Follows-up on secondary insurance billing, Medicaid appeals and denials and commercial appeals

· Identifies late charges and credit corrections

· Adds insurance profiles

· Communicates appeals to insurance company regarding denials

• Handles discounts, clinical pre-certification issues

Department/Business Unit Functions:

· Verifies eligibility from various insurance agencies

· Retrieves patient accounts

· Addresses letters from Medicare, works with prompt pay issues

· Makes insurance follow-up calls

· Performs corrections and updates to the insurance master

· Files, faxes, copies and performs other clerical duties

· Performs data entry, work processing and correspondence duties

· Performs special projects as assigned

· Utilizes resources efficiently and effectively

· Maintains safe environment

• Participates in Performance Improvement activities

Required Experience

General Functions:

· Demonstrates required skills for communication with various health insurance providers

· Possesses moderate billing knowledge, with the ability to perform remittance review and analysis

· Follows-up on secondary insurance billing, Medicaid appeals and denials and commercial appeals

· Identifies late charges and credit corrections

· Adds insurance profiles

· Communicates appeals to insurance company regarding denials

• Handles discounts, clinical pre-certification issues

Department/Business Unit Functions:

· Verifies eligibility from various insurance agencies

· Retrieves patient accounts

· Addresses letters from Medicare, works with prompt pay issues

· Makes insurance follow-up calls

· Performs corrections and updates to the insurance master

· Files, faxes, copies and performs other clerical duties

· Performs data entry, work processing and correspondence duties

· Performs special projects as assigned

· Utilizes resources efficiently and effectively

· Maintains safe environment

• Participates in Performance Improvement activities