You’ll need
Certifications
✓Certification in Billing or Coding may substitute for experience.
✓Certification in Medical Billing or Coding.
Education
✓High School graduate or equivalent.
✓Associates degree or completed courses in computer science, communication accounting, billing or coding.
Qualifications
✓One (1) year of experience in patient and medical insurance follow up in a healthcare setting.
✓Proficiency with computers and software applications.
✓Knowledge of general office procedures.
✓Knowledge of payor environments, such as managed care
✓insurance contractual agreements and appeals process.
✓Excellent interpersonal and communication skills.
✓Advanced abilities in basic mathematical skills.
✓Experience in commercial; Medicare or Medicaid follow-up.
✓Ability to work independently.
✓Excellent verbal and writing skills.
✓Knowledge of billing and government programs.
✓Basic knowledge of the Fair Debt Collection Practices Act
✓f the False Claims Act as it pertains to the Patient Protection and Affordable Care Act, PPACA
✓general knowledge of ICD-9/10, CPT, and DRG codes
✓knowledge of the Red Flag Rule, created by the FTC under the Fair and Accurate Credit Transactions Act of 2003.
About the role
Monitors assigned encounters to ensure maximum collection of dollars by providing appropriate follow-up and documentation. Collaborates with other department staff in the organization, insurance companies, physician offices, and patients or guarantors. Complies with organization and department policies and procedures.