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Accumulate data from Patient Access and Health Information Management for the purpose of submitting compliant third party insurance and physician claims. Initiate all collection calls for payment on aged accounts receivable up to the point of self-pay collections. Generates reports for responsible insurance plans and maintains online collection worklists and online claims editing software for maximum efficiency. Ability to decipher reimbursement schemes for assigned insurance’s to complete the revenue cycle
Job Responsibility:
Accumulate data from Patient Access and Health Information Management for the purpose of submitting compliant third party insurance and physician claims
Initiate all collection calls for payment on aged accounts receivable up to the point of self-pay collections
Generates reports for responsible insurance plans and maintains online collection worklists and online claims editing software for maximum efficiency
Evaluate daily claim file using online claim editing software for submission of UB92 and 1500 claim forms
Initiate collection of aged accounts receivable through an automated collector work lists
Generate reports as needed for collection of aged accounts receivable
Evaluate insurance reimbursement schemes as needed to verify that payments and adjustments have been accurately recorded
Communicate with patients as needed for additional insurance or other information needed in order to process a claim
Requirements:
Maintains up to date knowledge of all Federal, State and Insurance specific billing regulations, policies, procedures and code sets
Retains knowledge of Hospitals Credit Collection Policy
Ability to decipher reimbursement schemes for assigned insurance’s to complete the revenue cycle
Uses the API payroll system to enter time worked, sick days, vacations and holidays
Uses Meditech to access and run reports
Uses Lotus Notes as a communication tool
Access provider web sites for verification of accounts
Successfully answers safety questions in the annual mandatory education packet