Generate claims for submissions to third-party payers (commercial and federal/state government sponsored programs). These claims result from products and services administered to patients from our customers. Perform duties and responsibilities daily to ensure completions of accounts.
Qualifications:
Pre-Employment Education and Experience: Minimum of a high school diploma or GED required. Post-Secondary education in a medical discipline highly desired. Two years billing and or collection experience necessary, preferably in the IV field.
Technical Skills: Knowledge of Windows, Word, and Excel highly desired.
Special Skills: Excellent telephone and communication skills essential. Ability to deal with a variety of personalities in a professional manner is mandatory. Ability to assimilate a large volume of knowledge, detail orientation and good follow-through skills are crucial. Ability to use logic as a problem-solving skill, and able to recognize trends to make decisions to improve business.
Duties and Responsibilities:
- Generate monthly patient statements
- Verify patient balances are accurate and correct
- Take patient calls & patient payments
- Prepare patient balance reports to submit to client
- Obtain billing information on a daily or weekly basis (depending on the frequency of the data transfers) to generate claims from a multitude of different softwares.
- Track claims that are pending due to missing or incomplete documentation (ie: HCFA, EOB, etc.).
- Bill/submit claims to copay programs in a timely fashion and within the timely filing period.
- Perform routine follow-up calls to copay programs to determine the status of claims that are not paid within the normal claim processing time frame for a payer.
- Submit appeals in a timely manner to ensure proper payment on outstanding claims
- Resolve partial payments and denials in a timely manner
- Provide exceptional communication for reimbursement customers within Accounts Receivable
- Identify issues and trends and communicate to management as needed
- Document notes clearly, concisely, and timely in Client’s software
- Prepare a write-off form with a description of the reason for the write-off when bad debt is identified and be able to assist others with write off questions and process.
- Miscellaneous duties as assigned.
