This position has responsibilities for patient accounts and collection; and customer service functions for Premiere Medical Resources, under the supervision of the Director, Billing and Patients Accounts.
Posts patient and insurance payments to the correct account within the prescribed timeframe with a 95% or higher accuracy rate.
Analyzes and follows up on accounts where underpayments or non-payments have occurred. This includes but is not limited to:
- Underpayments or “short-pays” from insurance companies
- Denials or non-covered service adjustments from insurance companies.
- Following-up with insurance companies when payment has not been received within the Prompt Pay Law guidelines, or as otherwise specified contractually.
- Correcting and re-billing COB/no coverage denials.
Analyzes and resolves accounts on which overpayments have occurred; processes paperwork if needed so refund is issued to appropriate party.
Responds to patient, physician and insurance company inquiries regarding various accounts.
Maintains working knowledge of industry rules, regulations, policies and laws, including but not limited to: Ohio Prompt Pay, HIPAA, CMS and Medicaid guidelines.
Other related duties as assigned.
High School Diploma or equivalent; associates degree preferred.
At least two years related experience, including billing in a physician office or billing company environment.
Exceptional communication and organization skills, as well as the ability to work independently and as part of a team.