Job description

Summary:
Ensures proper billing protocols are followed and information is captured entered and reviewed appropriately and in timely manner in order to maximize reimbursement.

Responsibilities:
Charge Entry
Reviews demographic and coding information for assigned responsibilities.
Verifies and updates insurance coverage
Researches discrepancies regarding ICD HCPCS and CPT concerns and provides problem resolution
Creates claims for medical billing
Applies patient payments as necessary
Management of clearing house claims rejections

Payment Posting
Responsible for accurately and timely posting payments from all sources including (but not limited to) EOBs from all insurance carriers and patient payments.
Audits all payment and adjustment entries for accuracy
Balances payment batches while maintaining the highest level of quality assurance
Researches discrepancies and provides problem resolution
Researches and resolves any payment posting issues or discrepancies such as take backs forwarding balances or overpayments
Maintains daily posting logs and ability to meet month end deadlines
Validation of imported ERA files into Practice Management System

Accounts Receivable
Responsible for the collection of billed accounts and resolving outstanding receivables by performing collection and claim status follow-up activities processing appeals identifying and processing adjustments and other write-offs and accurately notating accounts in the system.
Verifies and updates insurance coverage
Researches discrepancies regarding ICD HCPCS and CPT concerns and provides problem resolution
Responsible for follow up of outstanding claims
Responsible for all activities related to denial management appeals and insurance overpayment resolution

General Billing Protocols
Complies with federal and local confidentiality laws including HIPAA ensuring patient privacy
Adheres to Coastal Medical guidelines and policies for protecting patients demographic clinical and financial information
Maintains work operations by following Coastal Medical's standards policies and procedures
Identifies and communicates issues and trends timely to management team
Performs other job-related duties as assigned

Lifespan is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Lifespan is a VEVRAA Federal Contractor.

Location: Coastal Medical USA: RI: Providence

Work Type: Full Time

Shift: Shift 1

Union:

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