Submit claims to government agencies, medical service bureaus and insurance companies. Answer all information requests from those payers, and trace all claims to those payers making sure they have been paid or denied appropriately and in a timely manner. Post payments, follow up on insurance rejections, submit claims to secondary insurers, calculate the precise patient responsibility portion to be billed, and respond to patient queries.
Ensure patient satisfaction through timely and effective patient account maintenance including assistance with billing, third-party payments, adjustments, information verification and record maintenance.
Submit claims to government agencies, medical service bureaus, and insurance companies ensuring that accounts are billed appropriately by auditing charges to ensure accurate procedure codes, billing data and patient information submitted. Submit claims to secondary insurers as required. Ensure deposits balance to posting and resolve any discrepancies.
Effectively process patient, clinic and insurance correspondence, including requests for refunds and collections when warranted.
Interpret and communicate information regarding credit policies and procedures, billing practices, insurance submission and out-of-pocket patient responsibility.
Accurately and timely post private payments, insurance payments, disallows and/or denials to appropriate patient account, calculate patient responsibility, interpret explanation of benefit message codes, identify payment discrepancies by contacting insurance carrier, and determine if rebilling is necessary. Trace errors, record adjustments to proper accounts and determine the appropriate destination for unidentified funds.
Function as liaison between patients and clinic staff on claims, billing questions or insurance related issues. Act as a resource to physicians, providers, administrators and patients regarding health insurance claim policies, procedures and requirements.
Accurate batch balancing and reporting.
Respond to inquiries from agencies, bureaus, and insurance companies to assist in the claim payment process.
High School Diploma or GED equivalent required
A basic course in medical terminology, medical billing and/or accounting preferred
Within the last 18 months; 12 - 18 months charge and payment posting experience in a healthcare environment preferred
Some collection experience preferred
Demonstrates a commitment to service, organization values and professionalism through appropriate conduct and demeanor at all times.
Adheres to and exhibits our core values:
Having a profound spirit of awe and respect for all creation, shaping relationships to self, to one another and to God and acknowledging that we hold in trust all that has been given to us.
Moral wholeness, soundness, uprightness, honesty and sincerity as a basis of trustworthiness.
Feeling with others, being one with others in their sorrows and joys, rooted in the sense of solidarity as members of the human community.
Outstanding achievement, merit, virtue; continually surpassing standards to achieve/maintain quality.
Maintains confidentiality and protects sensitive data at all times.
Adheres to organizational and department specific safety standards and guidelines.
Works collaboratively and supports efforts of team members.
Demonstrates exceptional customer service and interacts effectively with physicians, patients, residents, visitors, staff and the broader health care community.
Catholic Health Initiatives and its organizations are Equal Opportunity Employers
Administrative and Clerical
ND-Dickinson-St Joseph's Hospital And Hlth
Scheduled Hours per 2-week Pay Period
For Catholic Health Initiatives (CHI), returning sick people to good health is more than a business -- it's a mission. Formed in 1996...