Lead Biller

REPORTS TO: Supervisor Patient Accounts

General Description:

Patient Accounts Representative contributes to the department by the implementation and maintenance of an effective system for billing all insurance claims for our patients as well as collecting on third Party balances due on accounts. Works closely with other Team members to effectively gather and process billing and collection information. Works directly with the other Team members to ensure accurate and timely billing of problem accounts.

ACCOUNTABILITIES:

• Bills accounts in a timely manner utilizing the claims system to insure all third party payers responsible for accounts that have been billed.
• Identifies any billing problems, which cause delays and communicates these issues to the department head.
• Resolves problem accounts independently using sound judgment and following established policies and procedures.
• Organizes workload to meet deadlines by processing claims in an accurate and timely manner, meeting established productivity goals.
• Keeps abreast on regulatory changes affecting billing. Maintain current knowledge of State Insurance Commission Regulations and Managed Care payment requirements.
• Responsible for contacting insurance claims-paying departments in order to ask for payment on unpaid Third Party balances in a professional manner.
• Obtains and documents reasons for payment delays and asks for a definite date on which payment will be expected.
• Utilizes the online system indicators to establish and maintain a record of all transactions whenever possible in order to minimize the use of paper records.
• Works with all Third Party payer representatives in a confidential and discreet manner in order to ensure the confidentiality of all financial and medical information.
• Responds to cash flow slow down by increasing the pressure on Third Party payers through persistent and professional contact.
• Troubleshoots and resolves problems accounts and patient concerns during the telephone call, when possible.
• Completes all special assignments as requested.
• Be an effective team member participating with all staff assigned within the revenue cycle area and be an effective communicator.
• Participates in all mandatory safety, competency, and informational programs.
• Contributes to the mission, vision & values of Ray County Memorial Hospital
• Participates in problem solving and attaining goals of performance improvement projects and patient satisfaction
• Other duties as assigned.

QUALIFICATIONS:

• Able to work independently with little oversight and direction
• Able to work well with others
• Strong sense of work ethic and customer service
• Able to multitask
• Knowledge of Insurance billing required
• Experience with EPIC preferred
• Simple Math

EDUCATION:

• High School graduate with emphasis on Business Courses

PHYSICAL DEMANDS:

For physical demands of position including vision, hearing, repetitive motion.

Reasonable accommodations can be made to enable individuals with disabilities to perform the essential functions of the position without compromising patient care.