About the role
Schedule: Day Shift. 40 hours weekly. 8:00am – 5:00pm
Type additional details specific to position and/or department.
About The Position This position performs day-to-day billing and follow-up activities within the revenue cycle operations. Responsible for ensuring assigned insurance balance does not age past filing deadlines based on payor’s specific requirements.
Overview Of Responsibilities
- Verifies insurance coverage by investigation or interview.
- Follows up on accounts with insurance payers in a timely manner to avoid timely filing losses.
- Adds account notes in Epic as appropriate and per department expectations.
- Works an acceptable number of accounts based on department productivity standards.
- Utilizes telephone contacts, faxes, Internet, or other methods to follow up with payers.
- Reviews insurance credit balances and refunds payer when appropriate.
- Engages management when a claim is approaching the timely filing limit and is unsure how to get it paid or if the insurance/other responsible party is unresponsive.
- Requests and completes re-bills as necessary.
- Notifies management when payers are unresponsive.
- Responds to requests for information from patients or payers about claims or coverage.
- Actively participates in payer representative meetings to resolve issues.
- Follows compliance with laws, regulations, and guidelines of federal and state programs, emphasizing fraud, waste, and abuse prevention.
- Completes other duties and projects as assigned to support department goals.
- Actively participates in area and department meetings.
- Attends other meetings as requested.
This list of duties and responsibilities is not intended to be all-inclusive and can be expanded to include other duties or responsibilities that management deems necessary.
Education & E xperience
- Education Required: High School Diploma
- 2-3 years of experience in medical billing or insurance.
- Knowledge of government medical programs such as Medicare, Medicaid, Champus, etc., and the associated payment methodologies is preferred.
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