Responsible for the billing, collecting, and working of accounts from third party payors and patients/residents to resolution. Completes all necessary insurance claim requirements. Follows up on unpaid claims. Responds to inquiries regarding accounts, providing satisfactory explanation of patient/resident charges and/or account status.
1. Reviews and prepares insurance billing for completeness and accuracy, making necessary edits and corrections to claims prior to submission.
2. Contacts patient/resident, employer, etc. to obtain necessary information to file insurance claims.
3. Processes late charges and other account adjustments to patient accounts.
4. Reviews and works audit trails on outstanding accounts.
5. Handles follow-up of unpaid balances with insurance companies and patients/residents by use of statements, collection letters, re-bills, or phone contact.
6. Collects charges not covered by insurance or makes satisfactory payment arrangements.
7. Reports bankruptcy and estate claims to collection attorney and adjusts account as necessary.
8. Handles follow-up for outstanding balance due on past due contractual payment agreements.
9. Records and documents all activity occurring on an account.
10. Processes/posts remittances from Medicare, Blue Cross/Blue Shield, Medicaid, and other major third party payors. Processes remittance rejections in accordance with established guidelines.
11. Processes/posts payments from patients/residents.
12. Balances and audits work as required.
13. Investigates credit balance accounts, completes requests for processing.
14. Trains and assists facility personnel in computer programs used in billing office procedures as assigned.
15. Receives and resolves inquiry from patients/residents, their representatives, insurance companies, and attorneys. Documents discussions regarding an account.
16. Performs general office duties to include answering telephones, maintaining supplies and processing return mail.
17. Provides support for record maintenance and office filing requirements.
18. Performs research of Medicare bad debts, daily census, month end and other periodic reports as requested.
19. Performs other responsibilities and special projects as directed.
High school diploma or equivalent required. Minimum of one (1) year of related experience in a medical business office environment required.