JOB SUMMARY:

Responsible for managing patient account balances including accurate claim submission, compliance will all federal/state and third party billing regulations, timely follow-up, and assistance with denial management. 

RESPONSIBILITIES:

• Submits accurate and timely claims to third party payers. 
• Resolves claim edits and account errors prior to claim submission. 
• Performs daily tasks in appropriate sequence to achieve optimal productivity, accountability and efficiency. 
• Contacts third party payers to resolve unpaid claims. 
• Utilizes payer portals and payer websites to verify claim status and conduct account follow-up. 
• Researches and processes mail returns and claims rejected by the payer. 
• Reconciles billing account transactions to ensure accurate account information  
• Processes billing and follow-up transactions in an accurate and timely manner. 
• Develops and maintains working knowledge of all federal, state and local regulations pertaining to hospital/physician billing. 
• Monitors accounts to facilitate timely follow-up and payment to maximize cash receipts. 

EDUCATION and EXPERIENCE:

• High School diploma or equivalent. 
• Must have 2 years experience with hospital billing.  
• Must have a coding certification.
• Excellent oral and written communication skills. Working knowledge of computers, medical terminology preferred, understanding of business math and ICD-10  

PHYSICAL REQUIREMENTS:? 

• Must be able to sit for extended periods of time. 
• Must have reading and comprehension ability. 
• Must be able to communicate effectively. 
• Must have manual dexterity to operate keyboards, fax machines, telephones and other business equipment.