Description:

Job Summary Responsible for the timely submission of technical or professional medical claims to insurance companies. The position may be located in physician offices, hospitals, nursing homes, or other healthcare facilities. Duties and Responsibilities Verifying authorizations are listed for needed procedures. Verifying eligibility edits and notify admissions with errors. Reviewing patient bills for accuracy and completeness while obtaining any missing information. Preparing, reviewing for accuracy, and transmitting claims using billing software, including electronic and paper claim processing. Following up on unpaid claims within standard billing cycle timeframe. Assists with the distribution of mail. Greet all patients, families and hospital visitors with a positive, cheerful attitude. Answering telephones, using proper identification, responding appropriately to all hospital departments, physicians, patient families and visitors. Following up with Medical Records for unresolved Coding and Diagnosis errors. Run late charge report and correct claims as needed. Checking each claim payment for accuracy and any denied lines. Calling insurance companies and follow up on any outstanding issues. Identifying and billing secondary or tertiary insurances. Research and appeal any denied claims. Reviewing accounts for insurance of patient follow-up. Answering all patient or insurance telephone inquiries pertaining to assigned accounts. Follow-up with patients / attorneys / workman comp issues to get accounts resolved in a timely manner. Actively engage in quality improvement activities. Performs other duties as assigned.

Requirements:

Minimum Requirements High school diploma or equivalent 1-3 years of experience in a medical office setting Ability to communicate effectively in English, both verbally and in writing Preferred Requirements Associate's degree in Business Administration, Accounting, or Health Care Administration 2 years customer service experience Bilingual (English & Spanish) Skills/Competencies Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization. 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. Physical Requirements Perceive the nature of sounds by the ear, express or exchange ideas by means of spoken word, perceive characteristics of objects through the eyes, extend arms and hands in any direction, seize, hold, grasp, turn, or otherwise work with hands, pick, pinch, or otherwise work with fingers, perceive such attributes of objects or materials as size, shape, temperature, or texture; and stoop, kneel crouch, and crawl. Must be able to lift 25 pounds maximum with frequent lifting, carrying pushing, and pulling of objects weighing up to 50 pounds. Continuous sitting, walking, and standing. Must be able to identify, match, and distinguish colors. Rare lifting of greater than 50 pounds.