INSURANCE BILLING FOLLOW UP (PRN, AS NEEDED)

I. Job Summary

Handles all activity relative to billing of all insurance claims. Making sure corrections are done

in Paragon & Claims Billing Software System are completed to ensure that production of clean claims for

rebilling. Works CRC report daily and forwards to appropriate person responsible for following up

and completing.

Assignment requires planning and arranging all billers' work to accomplish/complete daily/weekly job duties. Applies own knowledge to solve routine operational problems. Must be able to handle a variety of tasks while meeting established deadlines.

II. Duties And Responsibilities

• Downloads all accounts from Paragon system each morning. Audits all accounts for missing charges and missing requirements. when this is completed, transmits correct completed claims. Furnishes needed claim information to assure payment. Assists with correspondence.
• Establishes a patient file for claims in need of diagnosis information and/or coding. Enters needed information on the claims.
• Ensures rejected claims have proper codes and enters such requirements and/or changes the Paragon system and rebills the claim.
• Maintains knowledge of all Commercial payer requirements. Maintains file of alerts and bulletins and distributes to appropriate staff that may pertain to.
• Assists with special projects assigned by the PFS Director
• Typing is required
  
  

III. Education

• A high school diploma or the equivalent is required.
• Post high school business training is desirable.
  
  

IV. Qualifications And Experience

Prior experience in a medical office or business office setting with an emphasis on adult public contact and attention to detail is required.

V. Physical Demands

• Hear and understand both face-to-face and telephone conversations.
• See sufficiently to complete forms, read instructions and use calculator for mathematical computations.
• Converse appropriately with individuals both inside & outside the hospital.
• Give and receive simple and complex instructions.
• Read and understand written language.
• Concentrate on, and remember varied job duties.
• Prioritize work of position.
• Solve problems ranging from simple to complex.
• Use both hands for typing for long periods of time, filing, etc.
• Carry less than 10 pounds on a regular basis and up to 25 pounds occasionally.
• Work requires sitting at desk for long periods of time to complete paperwork, type and converse on telephone.
• Must be able to perform the essential functions of the job without being a danger (liability, risk, etc.) to self or others.
  
  

VI. Working Conditions

Works in a well lighted, well ventilated office environment. Activity level is high with constant traffic in and out of department. Noise level is often a problem. Interruptions are very frequent.

VII. Acknowledgment

This is not necessarily an exhaustive list of all responsibilities, skills, duties, requirements, efforts, or working conditions associated with the job. While this is intended to be an accurate reflection of the current job, management reserves the right to revise the job or to require that other or different tasks be performed when circumstances change ( e.g., emergencies, changes in personnel, workload, rush job, or technological developments).