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Medicare Biller/ Medicare Collector 813049
2 months ago
- Submits all clean claims to the appropriate insurancepayer the same day the claim is loaded into the Editor with theexception of weekends and Holidays
- Reviews payer EOB’s but not limited to payment accuracy,patient liability, updating the financial class, notify commercialbiller to submit secondary or tertiary insurance, and appealgrievance.
- Files appeals on denied claimsand/or forwards to the Nurse Auditor for review/appeal
- Enter denials on the Denial Log
- Enter the USPS tracking number in the Patient Accountssystem
- Enter the USPS delivered date in thePatient Accounts system
- Contact payer toensure an appeal was received
- Maintain betterthan an 80% clean claim average.
- Attach butnot limited to the medical records, implant invoice, and itemizedbill to the claim before billing if applicable
- Process incoming mail correspondence from the payerswithin 3 business days
- Work assigned billingreports within 2 business days
- Work therejection report daily to resolve problem accounts
- Follow up with the payer via phone and/or the website forthe status of outstanding claims
- Respond topatient inquiries within 2 business days
- Respond to interdepartmental inquiries within 2 businessdays
- Respond to payer requests within 2business days
- Respond to emails within 2business days
- Submit newborn notifications ifapplicable
- Review/resolve the accounts on theUnbilled Report daily (accounts that are on hold and haven’t beenprocessed by the editor).
- Enter detailed notesexplaining account activity in the Patient Accountssystem
- Process payments over the phone ifapplicable
- Print UB and 1500 hardcopy claimswhen required by the payer
- Submit primary,secondary and tertiary claims before the timely filingdeadline
- Research late charges to determinethe cause; inform supervisor of regular occurrences andtrends
- Report A/Raccount trending issues to the Supervisor and the Director ofPatient Financial Services
- Follow up with allinsurance companies within 30 days of billing if there is nopayment on the account
- Work the eScan reportstimely if applicable
- Forward patientcomplaints regarding care to the supervisor for entry into theappropriate resolution pathway
- Notifysupervisor of payers that accept electronic billing currentlybilled hard copy
Requirements
Education
Preferred:
HighSchool
Licenses &Certifications
Preferred:
C-Heartsaver
