Works under the supervision of the Patient Financial Services Manager. Processes bills accurately and timely. Manages all unpaid insurance accounts. Meets insurance collection and A/R benchmarks. Performs other duties as assigned.
PRIMARY JOB DUTIES
Ensures superior ongoing patient satisfaction and customer service.
Is proficient in Practice Management software applications for A/R Management, Registration, Chart and Reporting.
Follow up on unpaid accounts for assigned alphabet beginning 30 days from initial billing to ensure correct information has been received at the respective payers.
Processes electronic billing for assigned weeks
Completes all incoming insurance or patient mail to ensure payment.
Resolves all billing edits.
Researches credit balances and processes refunds to insurance companies on overpaid accounts within 30 days of the payment.
Submits paper claims, for secondary and supplemental insurance companies, with copy of primary EOB.
Tracking and resolving all denials received from remittances and correspondence within 1 week of receipt.
Complies with the hospital’s Corporate Compliance Program including, but not limited to, the Code of Conduct, laws and regulations, and hospital policies and procedures.
Must be free from governmental sanctions involving health care and/or financial practices.
Performs other duties as assigned.
Adheres to CCH policies and procedures.
Maintains confidentiality as per CCH policies and federal guidelines.
Actively participates in Strategic Quality Management for the department and organization. Actively participates in Customer/Guest Relations and Mandatory Education programs.
• Education: High School graduate or GED equivalent
Licensure/Certification: See Cardiopulmonary Resuscitation Certification Policy and Certifications/Education Requirements Policy.
• Experience: Prior hospital billing experience preferred. Prior customer service experience, Prior computer keyboarding and 10- key calculator experience. Medical terminology preferred.
• Essential Technical/Motor Skills: Inputting data/Typing, answering telephones, Copying, Speaking Clearly, Precise Hand/Eye/Foot Coordination, Fingering/Fine Dexterity.
• Interpersonal Skills: Ability to communicate effectively with co-workers and patients.
• Essential Physical Requirements: Able to work in a loud (noisy) environment, able to sit for long periods of time, may be required to lift up to 50 lbs. Ability to transfer paper work/reports to the proper place. Work is performed in an office setting, and may require reaching overhead and repetitive activity.
• Essential Mental Abilities: Ability to organize and prioritize workload, and to work with computers and various software programs. Ability to think quickly and handle various projects simultaneously. May require analyzing, explaining/teaching, attention to detail, memorization, assessing/evaluating, calculations, and problem solving/reasoning.
• Essential Sensory Requirements: Sufficient vision, hearing and speech to perform duties
Exposure to Hazards: OSHA CATEGORY III. Identified job duties do not have any anticipation for contact with blood, contaminated body fluids or tissues. Employees working in healthcare facilities have the potential to be exposed to hazardous materials including: Hazardous Chemicals/Drugs, Waste Anesthetic Gases, Radiation, Latex, Biological Hazards, Respiratory Hazards and Ergonomic Hazards. See Hazardous Materials in the Workplace Policy.