Overview:
Responsible for updating and verifying insurance coverage, ensuring all documentation needed to bill is obtained and accurate. Review Family Cost Share (FCS) agreements for accuracy. Prepare and send patient statements. Occasionally will assist billing specialist’s in day-to-day billing duties.
Responsibilities:
Verifies insurance coverage and assists in obtaining pre-authorization from insurance carriers, when necessary. Compiles and submits all required documentation to the insurance.
Processes patient statements, keys data, posts transactions, and verifies accuracy of input to reports generated.
Researches and responds in person, by telephone, or in writing to patient inquiries regarding billing issues and problems.
Follows up on submitted claims; monitors unpaid claims, initiates tracers; resubmits claims as necessary.
Posts and reconciles payments to patient ledgers.
Follows and reports status of delinquent accounts.
Review and process billing forms to verify accuracy.
Maintains patient demographic information and data collection systems.
Maintains billing/filing records in accordance with established protocol.
Performs a variety of general clerical duties and other routine functions.
Ensures strict confidentiality of financial records as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
Performs other duties as assigned.
Qualifications:
Must be proficient in the use of a personal computer with advanced level keyboarding skills
Must have strong interpersonal skills required in the areas of verbal and written communications, facilitation, customer focus, and professionalism
Must have strong listening, assessment, prioritization, organization, troubleshooting, and problem solving skills
Must have basic knowledge of CHIPS, Medicaid, Private Insurance, and other third party payer billing requirements
Must have a High School diploma or GED with a minimum of (2) years relevant employment experience
Must have knowledge of basic office and computer skills
Work Experience:
Minimum of one year experience in medical office setting
Education/Certifications/Licensure:
High School Diploma or equivalent