Full employer posting
Executes actions which promote timely, accurate and effective billing, follow-up, cash posting, problem resolution and positive customer service. Ensures all necessary information and proper documentation are provided. Monitors delinquent accounts in order to receive overdue payments and return accounts to current payment status.
Responds to customer inquiries regarding account status, resolves discrepancies and prepares adjustments as necessary. PERFORMANCE DIMENSIONS AND TASKS Essential Function 1. Consistently and accurately interprets insurance requirements and regulations. 2. . 3.
Verify all insurance billing functions have been completed prior to processing self-pay accounts. 4. Responsible for self-pay and insurance account balances for assigned payers. 5. Responsible for reviewing accounts, potentially making outbound calls and sending letters to patients and third-party companies to collect on delinquent medical accounts. 6.
Review account information to determine why claims weren't paid, and research denied claims. 7. Receive, open, and make contact calls on correspondence received through mail. 8. Verifies insurance payments and write-offs are correct before billing patient. 9.
Resolves billing problems in a timely manner. 10. Set up payment arrangements with patients and ensure all self-pay contracts are current. 11. Reviews and compiles list of self-pay account(s) that are delinquent and transfer to bad debt 12.
Accurately compiles and verifies cash deposits. 13. Maintain detailed records by filing of transactions and documents while entering detailed comments into the computer so that a complete and accurate audit trail is maintained. 14. Informs supervisor of difficulty with payment of accounts, claims or carriers on a regular basis. 15.
Document all work and calls performed utilizing action codes. 16. Research and post payments to correct account(s). 17. Ensures proper contractual adjustments are represented on account(s). 18.
Ability to complete assigned tasks within department standards and established timeframes 19. Complete provider credentialing and re-credentialing applications with contracted insurance companies and other accrediting entities. 20. Ensure all credentialing applications and forms are completed accurately, thoroughly, and timely. 21.
Monitor the status of each provider’s credentialing and re-credentialing applications. Follow-up with credentialing entities to ensure provider credentialing is completed in a timely manner. 22. Communicate the status of provider credentialing to applicable practices and upper management. 23.
Setup and maintain provider and practice information in online databases 24. Maintains copies of state licenses, DEA certificates, malpractice insurance, and any other required credentialing documents for all providers, including past applications. As well as track provider license and certification expirations to ensure timely renewals. 25.
Contact and follow-up with providers to ensure all pertinent information is received to process their applications. 26. Stay abreast of credentialing guidelines and office participation and non-participation with insurance companies. 27. Ensure that facility addresses are current with health plans, agencies, and other entities. 28.
Perform all other duties as assigned. QUALIFICATIONS Education & Experience Performs work under general supervision. Handles moderately complex issues and problems, and refers more complex issues to higher-level staff.
Possesses solid working knowledge of subject matter. Typically requires a bachelor's degree or 3 years work experience or equivalent combination of knowledge, skill or ability. Skill
Type at least 30 words per minute, have detail orientated data-entry skills. Proficient in Microsoft Office. Licensing
None Language
Bilingual (English/Spanish) Preferred Physical Demands: Must be able to sit up to six hours and stand/walk up to two hours. Must be able to lift and push between 10 and 20 pounds. Must be able to use hands repetitively for six hours or more.
Special Demands: Willing to perform repetitive tasks. Ability to work with others and to perform a variety of assigned tasks. DISCLAIMER: The preceding
has been designed to indicate the general nature and level of work performed. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job.
About the role
Executes actions which promote timely, accurate and effective billing, follow-up, cash posting, problem resolution and positive customer service. Ensures all necessary information and proper documentation are provided. Monitors delinquent accounts in order to receive overdue payments and return accounts to current payment status.