Responsible for posting insurance and personal payments/denials. Must communicate with the insurance company regarding EOB clarification. Responsible for sending refund requests with supporting documentation to insurance companies when an overpayment is received. Works patient credits and either transfers credit or requests refund for the patient. Will collect and distribute mail throughout the Business Office. Forwards Primary EOB’s to bill secondary, tertiary insurances.

DUTIES & RESPONSIBILITIES:

1. Responsible for collecting mail from the mail room and distributing to proper Business Office staff.
2. Posts insurance/personal payments as assigned according to participating insurance EOB’s. This includes communicating with the insurance company regarding EOB discrepancies
3. Posts co-pay, same day, and on account reports. In addition, provides daily total of each to the Reimbursement Specialist.
4. Communicates with the accounting department regarding daily deposits. Also completes the daily recap sheet and prepares checks to send to the accounting department.
5. Responsible for advising insurance companies of overpayments. Completes refunds for patients’ and insurance companies. Transfers patient credits.
6. Works co-pay reallocation, charge pending, and daily credit balance report.
7. Files daily batches, co-pay, same day, and on account reports and maintains drawer space.
8. Performs other office duties as required.
9. Attends OSHA initially at orientation and annually thereafter.

RELATIONSHIP WITH OTHERS: Must work effectively with fellow team members and Business Office staff as well as insurance companies.

EDUCATION/EXPERIENCE/KNOWLEDGE: High school graduate or equivalency.

PHYSICAL REQUIREMENTS: Requires sitting, standing, bending, and reaching. May require lifting up to 20 pounds. Requires manual dexterity sufficient to operate office equipment such as computer, fax, calculator, and telephone. Requires normal hearing and vision.

Under the Supervision of the Business Office Supervisor is responsible for the timely and accurate follow-up of claims submitted to assigned insurance carriers.

DUTIES & RESPONSIBILITIES:

• Responsible for follow–up of insurance claims through the use of PCS and other mechanisms as directed by management.
• Responsible for general knowledge of payer rules and contract guidelines and billing procedures in order to accomplish follow-up activities.
• Responsible for review and correction of denied claims in accordance with rules and regulations both Federal and carrier specific.
• Will assist Correspondence Team in answering patient inquiries.

RELATIONSHIP WITH OTHERS: Must interact well with providers and clinical staff as well as payer staff and the staff and management in the Business Office. Must exhibit a high degree of attention to detail.

EDUCATION/EXPERIENCE/KNOWLEDGE: High School graduate or equivalent.

Compensation range: $16.50 to $25.74 (minimum to maximum range)