Position Summary:Supports the financial position through accurate and timely billing of claims and collection of monies owed to the hospital. Bill appropriate insurance companies. Knowledgeable and adhere HIPAA guidelines. Assist patients with financial arrangements, review credit history, and gathers patient/resident information. Contact patient and third party collect payments, reviews patient charts for accuracy and verifies insurance, prepares patient statements as necessary.

Responsibilities:

• Review claims for accuracy and completeness.
• Knowledge of insurance billing guidelines for Commercial, Medicare and State Medicaid.
• Complete follow-up on unpaid claims within contracted guidelines.
• Check Insurance payments for accuracy and compliance with contracted discount.
• Contact insurance companies regarding any payment discrepancy identified.
• Identify and bill secondary and tertiary insurances.
• Review accounts for insurance payment and patient self pay follow-up.
• Answer patient/insurance inquiries pertaining to assigned accounts.
• Knowledge in Excel and Word, Emdeon, DDE, Availity, PC Ace Pro, and My Ability a must.
• Strong interpersonal, analytical, computer, problem solving, and writing skills, all with a positive self-motivated attitude.
• All other duties as assigned

Minimum Qualifications:

Education: High School Diploma/GED required. College degree preferred.

Experience: Two (2) years business office experience preferred. Experience with insurance companies and a working knowledge of insurance terms, rates, policies, reimbursement procedures, UB-04 claim form, and CMS 1500 claim form is a must.

Competency: Position and Age-Related

HIPAA: Has access to all PHI necessary to perform job functions and assuring compliance with standards of care.

Work Demands/Environment:

Ability to stoop, lift, finger – for example pick, pinch, or type and grasp, ability to clearly and concisely express and exchange ideas via spoken word conveying detailed information to others accurately and on occasion quickly. Ability to perceive the nature of sounds with no less than a 40 db loss @ Hz, 1000 Hz and 2000 Hz with or without correction; ability to receive detailed information through oral communication, and to make fine discriminations in sound. Exerting up to 10 to 1 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. Ability to inspect and analyze figures, accounting items, written materials, newsprint, computer terminal characters, transcription and other similar objects at distances generally close to the eyes. This is a minimum standard based on the criteria of accuracy and neatness of work. The worker is subject to inside environmental conditions: Protection from weather conditions but not necessarily from temperature changes. Although inside work is the rule, it is required that the individual be able to travel.