Under direction, performs billing and accounts activities that maximize insurance reimbursement and promote faster payments; reviews insurance receivable for departments and notifies manager of potential problems; performs extensive account follow-up activities through GE CB paperless collection system module; investigates and analyses problem accounts; takes appropriate action, adjustments, write-offs and makes collection referrals on delinquent accounts; utilizes explanation of benefits to post rejection codes into GE CB rejection module; researches accounts and resolves disputes; performs follow-up on unpaid insurance claims; contacts third parties to expedite payments; monitors payment patterns and alerts management to deviations; prepares letters of appeal to insurance carriers that were paid at incorrect rate; appeals denied claims; answers inquiries from patients and insurance companies regarding unpaid physician charges; explains billing procedures and communicates with third party payers eligibility, misdirected payments, billing problems an disputes; utilizes tools such as Eagle, Navinet and EPACES to retrieve patient insurance and demographic information and update in GE CB; responds to requests for information from patients and insurance carriers by retrieving source documents such as medical records and referrals by accessing computer applications such as ImageCast, EPIC and Eclipsys XA; performs charge corrections as needed; processes insurance information to ensure claim is generated via electronic media or paper; monitors ticklers through PCS module for aggressive account follow-up; makes corrections to system to satisfy system edit requirements and re-submit claims as needed; reviews and resolves ClaimLogic rejections and edits; refers accounts to In House Collection division for follow-up; explains billing procedures to patients and insurance companies; performs other job related duties as required.
Must have a high school diploma and two to four years physician, accounts receivable and collection experience; College degree preferred; must have understanding of third party healthcare reimbursement regulations, ICD-9 and CPT coding; proficient in Microsoft Office Suite and able to access specialized healthcare websites via the world wide web; excellent organization and communication skills.
No relocation assistance is provided for this position.
Visa sponsorship is not available for this position.
Founded in 1898, and affiliated with what is now New York-Presbyterian Hospital since 1927, Weill Cornell Medical College is among the top-ranked clinical and medical research centers in the country. In addition to offering degrees in medicine, Cornell also has Ph.D. programs in biomedical research and education at the Weill Graduate School of Medical Sciences, and with neighboring Rockefeller University and the Sloan-Kettering Institute, has established a joint MD-PhD. program for students to intensify their pursuit of Cornell's triple mission of education, research, and patient care.
Weill Cornell Medical College's educational mission emphasizes the importance of combining a strong foundation in the medical sciences with extensive clinical training in patient care. By promoting a true social commitment, stimulating creativity, and fostering independent thought and study, Weill Cornell Medical College continues to cultivate the best of tomorrow's leaders in the field of medicine.
Weill Cornell Medical College is an equal opportunity, affirmative action educator and employer.
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