Position Summary: Responsible for all aspects relating to patient accounts, billing, claim adjudication, collections and payment posting.

• Essential duties and responsibilities (3-5 core functions representing 80% of time spent):

• Scrub and review charges daily to ensure correct insurance/demographics, correct diagnosis and treatment codes and modifiers to ensure claims are correct and free from error. Transmit to clearinghouse daily.
• Payment posting and/or review of any EDI payments to ensure posting accuracy.
• Work denied or unpaid claims to determine reason for denial and claim correction, if applicable, and either resubmit for processing, follow-up with insurance payor, and/or education of clinic staff on reason for denial.
• Research and resolve all credit balances.
• Manages and audits client accounts. Ensures correct payor is identified and entered into the financial section of the EHR
• Process weekly patient statements.
• Answers patient questions regarding co-pays, deductibles, write-offs and other patient related billing questions. Resolves patient complaints and offers information to help explain why certain services may not be covered.
• Answers questions by clinical staff, physician, and insurance companies and identifies and resolves patient billing complaints.
• Reviews claims and authorizations and issues retrospectively.
• Serves as a liaison between accounting and the rehabilitation department ensuring good communication and accurate accounting of all patient transactions.
• Assist in credentialing/enrollment with insurance payors to ensure in-network status and to facilitate timely payment of claims.
• Reports all issues and/or concerns with insurance and patients to the Practice Administrator and Chief Financial Officer.
• Ability to look up ICD 10 diagnosis and CPT treatment codes from online service or using traditional coding references. Assigns appropriate corresponding ICD 10 codes to make sure medical facilities are accurately billed whenever physicians make a diagnosis or treatment plan.
• Assists patients in establishing a payment plan for past due accounts ensuring the payment plan is consistent with the practice guidelines set forth by the Director or Rehabilitation Services. Works in conjunction with Practice Administrator to identify grants and/or scholarship monies that are available to assist patients who have a financial need.
• Prepare reports by collecting, analyzing, and summarizing information.
• Assist in answering phones and working referrals to schedule patients.
• Accomplishes organizational goals by accepting ownership for accomplishing new and different request and exploring opportunities to add value to job accomplishments.
• Follows HIPAA guidelines in handling patient information.
• Must wear all protective equipment required by department.
• Must follow all company policies and procedures including departmental safety policies.
• Performs all other duties as assigned.

• High school diploma, plus 2 years administrative, or office experience required.
• Experience in a health care related setting preferred.
• Preference given to candidates with prior medical office management or medical billing experience. Attention to detail and accurate data entry are a must.