Insurance Biller- 813051
2 weeks ago
- Submits all clean claims to the appropriate insurance payer the same day as the claim is loaded into the Editor 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 the Nurse Auditor for review if applicable
- Maintain better than an 80% clean claim average.
- Attach but not limited to the medical records, implant invoices, and itemized bill to the claim when applicable
- Process incoming mail correspondence from the payers within 5 business days
- Work assigned billing reports within 2 business days
- Follow up with the insurance companies by phone and or web for the status of outstanding claims if applicable
- Respond to patient inquiries regarding the status of the patient’s insurance within 2 business days
- Submit newborn notifications to income support if applicable
- Review/resolve the accounts on the Unbilled Report daily (accounts that are on hold and haven’t been processed by the editor).
- Enter detailed notes explaining account activity in the Patient Accounts system
- Take payments over the phone.
- Print UB and 1500 hardcopy claims when required by the payer
- Bill secondary claims before the timely filing deadline
- Research late charges to determine the cause; inform your supervisor if they are a regular occurrence.
- Handle incoming correspondence and inquiries on accounts.
- Report trends/issues to Supervisor and the Director of Patient Financial Services
- Follow up with all insurance companies within 30 days of billing if there is no payment on the account if applicable
- Forward patient complaints regarding care to your supervisor for entry into the appropriate resolution pathway
Requirements
Education
Required:
High School
Licenses & Certifications
Preferred:
C-Heartsaver
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