Duties and Responsibilities

• Prepare and submit insurance claims electronically and manually to commercial insurance companies, Medicare, Medicaid, and other third party payers
• Review patient accounts for billing accuracy and completeness 
• Verify patient insurance information and eligibility prior to claim submission
• Follow up with insurance companies regarding denied, delayed, or unpaid claims 
• Research claim status, resolve billing discrepancies and claim rejections 
• Post insurance payments and adjustments to patient accounts 
• Maintain detailed records of collection activities and account updates
• Collaborate with coding, registration, and clinical departments to correct claim information 
• Appeal denied claims when appropriate 
• Work aging reports and prioritize outstanding balances 
• Communicate with patients regarding billing questions and payment arrangements 

Regulatory Requirements

• Completes annual educational requirements within the assigned time frame
• Maintains regulatory requirements, including all state, federal and Joint Commission regulations related to their department and, as appropriate, to the hospital.