DUTIES AND PERFORMANCE EXPECTATIONS:

• Posts insurance remittance advices and other payments.
  • Prepare and balance daily deposits.
  • Balance payments and adjustments with remits.

• Pursues collection of all claims until payment is made by insurance companies.
  1. Follow-up with third party insurance carriers on unpaid claims until claims are paid or only self-pay balance remains.
• Works all appeals, denials and rejections in a timely fashion and within requirements set forth by the payer and departmental standards.
  1. Correct any billing error by resubmitting claims to third party insurance carriers or handling otherwise as appropriate.
  2. May require research and communication as appropriate.
  3. Works with therapist or medical record staff to ensure that correct diagnosis/procedures are reported to third party insurance carriers.
  4. Monitors claims for missing information.
  5. Responsible for re-billing, preparing and submitting claims to insurance carriers, primarily electronically.

• Payer coordination and outreach.

1. Keeps updated on all third party billing requirements and changes for insurance types within their area of responsibility.

• Maintain patient confidentiality at all times.

• Recognize problem accounts and notify appropriate staff or supervisor to assist in problem resolution.
• Secures needed medical documentation required or requested for claim payment.
• Assists patients, therapists, and payers with problems or questions regarding their claims and/or policies.
• Obtain and/or enter such documents as authorizations, financial agreements, and other such ancillary documents as may be necessary.

• Contribute to the AR department team through positive attitude, respectful interaction with co-workers, innovative ideas, efficiency, and ethical behavior.
  • Openly communicate with immediate supervisor.
  • Good attendance, notifying supervisor during absences.
  • Identify problems and constructively participate in problem resolution.
  • Demonstrate positive rapport with staff members developing positive employee relations.

• Other duties as assigned.

POSITION REQUIREMENTS:

• Strong interpersonal skills to effectively interact with patients, vendor/payer contacts and other staff members.
• Strong self-motivational abilities.
• Must possess a high degree of accuracy.
• Must be highly detail oriented.
• Excellent written, communication, and analytical skills.
• Outstanding computer skills with billing software, Microsoft Office, able to learn computer other systems.

PHYSICAL DEMANDS/WORKING CONDITIONS:

• Work is performed in an administrative office or therapy clinic environment.
• Constantly operates a computer, telephone and other office equipment to perform duties.
• Must be able to remain stationary for long periods of time (up to 80%); frequently move about inside the office or clinic to access file cabinets, office machinery, etc.; as well as occasionally position self by bending or stooping to move equipment or files weighing up to 20 lbs.
• Inside under normal temperature conditions, adequate light, ventilation, and space. Works frequently with others, occasionally alone. Moderate exposure to noise typical of an office environment.
• Exposure to blood-borne pathogens, body fluids, equipment, and cleaning chemicals minimal with training and strict adherence to established department safety policies and procedures.