Job Summary Responsible for all or part of the following: billing and collecting, research, correspondence, payment and adjustment posting, charge entry, prior authorization, and a host of other duties to assure timely reimbursement to the medical provider. Demonstrates independent problem solving skills of account error necessary to bring the account balance to zero within established time frames. Leads up special projects when assigned. Assist with training and workflow changes.
Responsible for research and secure payment for insurance accounts:
Follow up required daily accounts based on work queue assignment to reduce the A/R,
Submit appeal letters on unpaid and underpaid claims,
Participate in accounts receivable collections projects as needed to meet department goals,
Handle escalated calls to insurance company supervisor to follow up on problem accounts regarding denials.
Contact patients regarding insurance related issues
Research recoups and repayments to assure that payments are accurate and comply with Medicare and Managed care contracts payment methodologies.
Work the electronic denial file (835b) to ensure clean claim submission.
Review Charge review work queues as assigned.
Research and request insurance refund requests.
Perform bad debt and non contractual adjustments as requested.
Monitor and trend denials seen in WQ and work with supervisor on workflow and education to staff.
Responsible for research and secure payment for patient balances:
Follow up required daily accounts based on account work queue assignment to reduce the cash pays A/R.
Submit final letters to delinquent accounts
Answer incoming patient calls
Handle escalated calls from patients regarding accounts when supervisor is off the floor.
Provide support to the clinics as needed during patient care hours.
Collection calls to patients to collect past due balances.
Process credit card payments and post within the patient billing system.
Set up payment plans for patients
Review statements to ensure accuracy
Acts as a liaison between patient, practice and insurance carrier regarding complaints and problems.
Work with statement and bad debt vendors on disputes and ensure accuracy of accounts.
Work return mail to update accounts to ensure accuracy.
Research and request patient refunds.
Performs routine data entry and/or review of claim edit work queues:
Input charges for physician billing
Correct denials that have dropped to the claim edit work queues timely
Maintains current knowledge of regulatory billing requirements for the specified payers and various specialty specific limitation or payer expectations.
Process the electronic claims batch daily and initiate the printing of paper claims.
Work with IT on upgraded CPT, DX and billing provider files to ensure claims are processed timely.
Trend and track registration batches received and assign as appropriate.
Review Charge review and claim edit work queues as assigned.
Follows departmental functions:
Act as a lead for the department team to help with special projects, assist with training and workflow changes.
Prioritize work to minimize interruptions and increase efficiency in collections process,
Participate in daily DMS huddle, and all department meetings,
Provide five star customer service, to include patients, coworkers, vendors and management,
Establish and maintain and efficient filing system,
Maintain clean and organized work area,
Communicates and engages effectively with others,
Communicates and participates in training classes as needed to keep current with daily operations
Work in a team environment and participate in constructive feedback.
Ability to handle numerous tasks simultaneously and with flexibility..
Assist supervisor with reporting and maintaining department spreadsheets.
Handles all payments and correspondence received in the central business office.
Processes all EFT/ERA, lockbox, mail, POS, phone payments.
Processes credit cards,
Creates payment batches and scans all correspondence into patient billing system,
Processes deposits for all incoming payment, including POS from multiple clinics.
Sets up courier service for new clinics
Posts payments and denials into patient billing system.
Processes ERA payments and works error work queue
Performs daily batch reconciliation for both CBO and clinic deposits.
Maintain posting spreadsheet and work with finance on month end balancing
Perform workflow education to practice managers and staff.
Follow up on credit work queues to maintain the undistributed credits, process refunds and research incorrect adjustments or payments.
Work with credentialing on on boarding physician and clinics to ensure proper routing of electronic payments.
Be the liaison for different teams to research payments on missing checks.
Process refunds once they have been approved.
Internal Number: 2018-13180
Let’s transform healthcare together.
Every day, we bring patients convenient, coordinated access to healthcare while providing meaningful service to our community.
Join us and you will:
Develop professionally and achieve your career goals
Enrich your life with a focus on wellness
Enjoy a compassionate, caring culture with outreach to our local communities
Support the well-being of you and your family with a diverse portfolio of benefits
Welcome to HonorHealth.
We are a non-profit, local healthcare organization known for community service and outstanding medical quality. Our organization encompasses five acute care hospitals with approximately 10,500 employees and 3,100 volunteers, urgent care centers, clinical research, medical education, an inpatient rehabilitation hospital, an Accountable Care Organization, two foundations, and extensive community services.