Under the general direction of the Director, Accounts Receivable, and the direct supervision of the Team Leader/Supervisor and within established departmental policies and procedures, the incumbent performs the following functions:
Verifies the correct entry of information into the billing system including but not limited to insurance information, diagnostic coding, type of bill, status code, dates of service and provider number. Ensures that bills are system generated as soon as possible following discharge. Reviews and sends bills to the proper insurer, either by mail or via electronic billing. Ensures that bills reflect the proper charges. Brings questionable items to the supervisor’s attention. Initiates adjustments to bills to reflect proper charges. Utilizes the Blue Cross VDT for follow-up or correction to Blue Cross and Medicare claims and to determine eligibility. Determines proper disposition of credit balances on accounts and initiates refund or transfer of funds. Reviews all action logs and responds. Retrieves information to provide documentation for adjustments and transfer of funds. Purges files. Exercises care in the operation and use of Optima Health equipment and reference materials. Ensures routine cleaning and preventative maintenance to ensure continued functioning of equipment. Participates in appropriate role in disaster and fire drills, fires and other emergency situations. Maintains confidentiality of all employee, legal, patient and company matters. Performs similar or related duties as required or directed.
• High school diploma or equivalent.
• Minimum two year’s medical billing experience in a health care setting preferred.