Job description
Full-time, 40 hours per week, day shift, flexible start and end time hours, Monday-Friday
SUMMARY:
Coordinates all patient, client and insurance billings for the medical facility. Maintains detailed knowledge and application of billing requirements for third party payors. Processes insurance payments to patients’ accounts and works to coordinate information on these accounts through communication with providers and patients. Assists patients in obtaining advance approval from a health plan before a specific service is delivered to the patient to qualify for payment coverage.
PURPOSE:
The purpose of this document is to describe the general nature and level of work performed by personnel as classified; it is not intended to serve as an inclusive list of all responsibilities associated with this position.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
- Maintains detailed knowledge of billing requirements and rules for third party payors.
- Assures all financial and demographic information is correct and complete.
- Assures that all allowances, discounts, co-payments are applied properly.
- Processes insurance payments to patient accounts in computerized system.
- Contact accounts, physician or patient to obtain any missing information needed to accomplish accurate billing records.
- Re-bills insurance companies or other third parties to secure payment for patients.
- Assists with the training of appropriate personnel on computerized billing system.
- Responds to patient/client billing and statement inquires through phone or mail correspondence.
- Obtains and mails invoice copies for customers, as requested.
- Researches and processes customer claims of invoice payment
- Answers accounts receivable phone inquiries and follows up with patient/client.
- Identifies overpayment by insurance companies or patients and issues refund request forms to Supervisor.
- Investigates insurance denials as necessary for maximum reimbursement.
Required Skills
QUALIFICATIONS:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Insurance experience and prior auth preferred.
Education/Experience:
High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience. Prior Auth experience preferred.
Language Ability:
Ability to read and comprehend simple instructions, short correspondence and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
Math Ability:
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions and decimals. Ability to compute rate, ratio and percent and to draw and interpret bar graphs.
Reasoning Ability:
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
Computer Skills:
Basic computer skills (windows, medical record software, MS Office, etc.) with proficient data entry skills of 40-50 wpm, in addition to basic knowledge of standard office equipment.
Certificates and Licenses:
No certifications required.
Required Experience
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