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JOB SUMMARY: Responsible for billing patients, processing third party payer claims, i.e., Insurance, Medicare, Medicaid, Worker s Compensation and other government assisted programs. Processing all correspondence and collections. Completes medical liens and bankruptcies. Processing secondary claims, answer telephone, insurance follow-up. Performance of job duties is done to meet or exceed expectations of Productivity Achievement, Accountability, Customer Service, including customer s rights, privacy and confidentiality. PREVIOUS EXPERIENCE NEEDED: Computer knowledge, accounting, business office machines. Knowledge of insurance and CPT/HCPCS s coding helpful. Knowledge of credit and collection practices, CMS and third-party regulations helpful. TRAINING & EDUCATION NEEDED: High school graduate with courses in business, computers, and accounting preferred. Hospital or medical-related experience preferred. Some college is helpful. FUNCTIONAL REQUIREMENTS: KEY: Infrequent (1-3 times per week) Occasional (1-3 hours per day or Frequent (3-7 hours per day or 33-66%) Constant (7 or more hours per day or >66%) Lifting: Must be able to lift 20 lbs from floor to waist on occasional basis. Must be able to push or pull 50 lbs on floor. Standing/Walking/Sitting: Must be able to sit from 5-8 hours Must be able to walk/stand for 1 hour intermittently Lower Extremity: Must be able to squat on occasional basis. Upper Extremity: Must be able to grip/grasp/pinch of paper/secretarial equipment on frequent basis. Equipment: Must be able to use computer and perform keyboarding on constant basis. View CRT s on a constant basis. Able to communicate (oral/written) in the English language. JOB DUTIES: Accurately process insurance and patient bills on a timely basis. Accurately reviews all adjustments for Medicaid, Medicare, Worker s Compensation, PPO discounts and others to ensure accuracy. Audits the insurance card information to ensure accuracy prior to billing and check for missing or incorrect information. Performs follow up on unpaid claims, files medical liens, estate demands, and bankruptcies as needed. Utilizes all available tools to manage accounts receivable efficiently including but not limited to: - Collection Letters - Aging Reports - Payer websites for eligibility and claim status and other on-line websites - CSNAP Medicare - 3M Coder - All available resources for billing/coding such as ICD and CPT books - WORD - EXCEL - Internet Insurance & Medicare Websites Accurately prepares the export function for claims to automatically export to the Clearinghouse for transmission. Accurately maintains all claims to pass edits for electronic filing and transmits on a daily basis. Efficiently collects payments daily and refers delinquent accounts for collection. Reviews all credit balances and makes adjustments or refunds as appropriate on a bi-monthly basis. Monthly receipts all reimbursement from collection agency, ARL, and completes necessary report. Consistently answers telephone calls and correspondence concerning patient billing in a professional, customer friendly and reasonable time. Complies with hospital/departmental norms for beaks and meals, ensure that the department is adequately staffed. Schedule patient appointments. Assist as needed with Clinic Receptionist duties. Must be detail oriented and have good organization skills. Complies with Attendance Management Policy in regards to attendance and timeliness, understanding the expectation of maintaining an absence percentage of 3% or less. Performs other duties as assigned by person in charge. by Jobble