Overview

SCOPE : Under general supervision, is responsible for account follow-up for all assigned accounts, resolving billing problems and answering patient inquiries.

Sets up financial arrangements as needed. Uses collection techniques to keep accounts receivable current including monitoring for delinquent payments.

• Reviews account agings on a monthly basis and reports inconsistencies and corrects errors as appropriate. -Contacts patients regarding delinquent accounts and arranges mutually acceptable payment schedules.
• Follows up on insurance billing to ensure timely receipt of payments. Demonstrates the ability to deal with patients and insurance companies regarding sensitive financial matters and recapture unpaid balances.
• Receives and resolves patient billing complaints and questions; initiates adjustments as necessary; follows up on all zero payment explanations of benefits and exercises all options to obtain claim payments.

Reviews credit balance reports for correct recipient of refund. -Performs reconciliation of refund accounts; attaches documentation and forwards to supervisor to process refund checks.

• Identifies problems on accounts and follows through to conclusion. -Responds to insurance companies requests for information in a prompt and professional manner.
• Reviews appropriate files to identify deceased patients and estates; verifies dollar amounts and files estate to appropriate court in a timely manner.
• Makes appropriate financial arrangements for payment of patient accounts; follows up to determine if payment arrangements are being met;

contacts patients to resolve problems; responds to correspondence or telephone calls from patients about accounts. -Reviews EOBs to ensure proper reimbursement of claims and reports any problems, issues, or payor trends to supervisor.

• Resubmits insurance claims within 72 hours of receipt. Participates in maintaining Payor Manuals / Profiles. -Works closely with collection agency to assure that they receive updated information on accounts as necessary.
• Prepares write-off requests with appropriate documentation and submits to supervisor. -Processes insurance / patient correspondence, including denial follow-up within 48 hours of receipt.

Files all reimbursement correspondence daily. -Works with provided aging to monitor patient account agings and follows up appropriately.

Maintains confidentiality in regards to patient account status and the financial affairs of clinic / corporation. MINIMUM QUALIFICATIONS : High school graduate or equivalent required.

Minimum three years experience in a medical business office setting with insurance processing and balancing responsibilities.

PHYSICAL DEMANDS : The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work may require sitting for long periods of time;

also stooping, bending and stretching for files and supplies. Occasionally lifting files or paper weighing up to 30 pounds.

Requires manual dexterity sufficient to operate a keyboard, calculator, telephone, copier and other office equipment. Vision must be correctable to 20 / 20 and hearing must be in the normal range for telephone contacts.

It is necessary to view and type on computer screens for prolonged periods of time. WORK ENVIRONMENT : The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work is performed in an office environment.

Involves frequent interaction with staff, patients and the public.

Last updated : 2024-04-27