- Evaluates EOB payment to determine transaction billed is paid in full according to current fees and contract. Rectifies any underpayments with the insurances for additional payment.
- Audits charts to verify documentation, such as the assignment of benefits, letters of medical necessity, authorization and other required documents.
- Performs manual or electronic processing of reimbursement claims.
- Ensures billing occurs in a prompt and timely manner as well as timely follow up.
- Works on claims, denials, suspension, appeals and aging reports to determine the appropriate follow-up action.
- Ensures that goals set for denials/correspondence and aged accounts are met within the set deadlines given by your supervisor.
- Maintains accurate and complete records concerning billing and collection activity including documenting the patient’s chart and system notes.
- Updates all patient information as necessary, request supporting documentation, copy of insurance card and other required information.
- Handles customer and insurance questions concerning account activity.
- Supplies supervisor or manager with current account status for collection evaluation.
- Shares with other team member’s relative billing, adjustment or collection information.
- Communicates problems and concerns with supervisor/ manager which may lead to inaccurate or untimely completion of reimbursement processing.
- Work on and follow up on other projects, as assigned.
- Performs other duties, as assigned.
Work Experience Requirements:
- Graduate from an accredited high school
- Two year experience in collections
- Knowledge of medical insurance payers, billing rules and regulations.
- Experience in healthcare, medical and/or HME industry (preferred).
- Computer literate and knowledge of USS program is a plus.
- Make best use of work time to complete projects and assignments as scheduled.
- Be able to work on multiple tasks. Plan and prioritize activities to achieve results and meet deadlines.
