Identifies, reviews and interprets third party payments, adjustments and denials. Bills, monitors and analyzes unresolved third party accounts, initiating contact to ensure timely payment and account resolution.
Following current Central Billing Office policies and processes, analyzes and works assigned monthly A/R reports and assigned workqueues and initiates contact with carriers. Initiates re-billings, corrected claims and appeals and has an in depth understanding of assigned payer requirements. Uses resources (payer websites, coding books, education alerts, processes and policies) to complete all assigned tasks ensuring first time and corrective processing from the carrier. Monitors assigned payer(s) days in A/R and ensures they are maintained at the levels expected by management and implements independent follow up processes on accounts worked to ensure payer response. Achieves acceptable audit results and meets productivity standards set by the department. Identifies denial and non-payment trends for the assigned payer and reports them to management. Maintains an in depth knowledge of the software system in areas related to billing and registration. Develop personal skills and capability through on-going training, as provided by the department/company or elsewhere subject to company approval.
High School Diploma required. Associate’s Degree or previous experience in physician billing preferred.
Minimum of 1 year working in the related field preferred. Understanding of computer billing systems, knowledge of CPT and ICD-9 coding and overall insurance processing rules/regulations required. Excellent communication and organizational skills.
Elliot Health System is an Equal Opportunity Employer and an Affirmative Action Employer.
Elliot Hospital - 21 months ago