Biller / Collector

GENERAL PURPOSE:

Ensure the timely billing of all accounts, including but not limited to: the review of registration for accurate patient demographics and insurance information, the review of bills for correct billing information and charge accuracy, the submission of timely billing, the processing of payment and explanations of benefits, responding to correspondence and telephone inquiries, contact other departments as needed, follow-up of accounts assigned by work lists or trial balance reports, resolve billing issues related to denials and rejected claims, account note entry and the filing of accounts and documents as needed to perform the above functions and in compliance with departmental guidelines.

ESSENTIAL FUNCTIONS:

Ability to lift, walk, carry and stand. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements are represented of the knowledge, skill, disabilities to perform the essential functions.

DUTIES AND RESPONSIBILITIES:

1. Utilizes Critical Access (CAH) rules and regulations for billing.

1. This position works in a cooperative team environment to provide quality customer service to internal and external customers.

1. Process billing for patient types manually and electronically (837)

1. Contact payer and or patient in accordance with the current facility collection policy.

1. Works aging reports to ensure timely clearance of accounts to meet/exceed AR aging benchmarks.

1. Assists patients with billing inquiries in a courteous and professional manner.

1. Assigns and communicates with team members when assigning accounts to be worked by them.

1. Completes accurately documentation of all account activities in Cerner.

1. Handles and resubmits re-workable denials back to the insurance company.

1. Work in the Medicare DDE when needed to see claims that have rejected and correct.

1. Report to the PFS Director monthly on any account rolling over 60 days with an explanation attached.

1. Other duties as assigned.

SKILLS AND ABILITIES REQUIRED:

1. Must have knowledge of Medical and Insurance terminology.

1. Must have knowledge of working accounts in the DDE.

1. Must possess computer skills, office, online insurance websites, online vendor applications, and any other office equipment needed to do the job successfully.

1. Experience with Inpatient and Outpatient billing required for hospital billing.

1. Knowledge of government, non-government, commercial, third party and workers compensation processing guidelines.

1. Working knowledge of Cerner for both patient accounting system and editing applications.

1. Computer skills to process accounts appropriately and enter account notes.

1. Ability to multi-task, prioritize needs to meet required timelines.

EDUCATION AND EXPERIENCE REQUIRED:

1. Familiar with CAH billing practices and reimbursement preferred.

1. High School Graduate/GED

1. One year experience of hospital or healthcare billing.

1. Analytical skills required to read, understand and identify and perform required functions.

1. Effective written and verbal communication skills.

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