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Insurance Biller
2 months ago
- Demonstrates knowledge and skills necessary to provideservices based on the physical, psychosocial, educational, safety,and other related criteria appropriate population in his/herassigned area
- Maintains required corecompetencies.
- Complies with set Policies andProcedures (i. e. name tag, dress code, parking, smoking,etc.)
- Submits all cleanclaims to the appropriate insurance payer the same day as the claimis received with the exception of weekends.
- Reviews payer EOB’s but not limited to payment accuracy,patient liability, and appeal grievances if applicable.
- Files appeals on denied claims and/or forwards to theLead Patient Account Analyst for review if applicable
- Maintain better than an 80% clean claimaverage.
- Attach but not limited to the medicalrecords, time records, and itemized bill to the claim whenapplicable
- Process incoming mailcorrespondence from the payers within 5 business days
- Work assigned billing reports within 2 businessdays
- Follow up with the insurance companies byphone and or web for the status of outstanding claims ifapplicable
- Respond to patient inquiriesregarding the status of the patient’s insurance within 2 businessdays
- Submit newborn notifications to incomesupport if applicable
- Review/resolve theaccounts on the Missing Slips Report daily (accounts that are onhold and haven’t been processed).
- Enterdetailed notes explaining account activity in Athena
- Take payments over the phone.
- PrintUB and 1500 hardcopy claims when required by the payer
- Bill secondary claims before the timely filingdeadline
- Research late charges to determinethe cause; inform your supervisor if they are a regularoccurrence.
- Handleincoming correspondence and inquiries on accounts.
- Report trends/issues to Supervisor
- Follow up with all insurance companies within 30 days ofbilling if there is no payment on the account ifapplicable
- Forward patient complaintsregarding care to your supervisor for entry into the appropriateresolution pathway
- Performs other duties asassigned
Requirements
Education
Required:
HighSchool
Licenses &Certifications
Required:
C-Heartsaver
