Balance payments posted to the system with deposits.
Check insurance eligibility and benefits.
Reviewing and sending claims to the clearing house or insurance company directly (when needed).
Correcting claims and querying providers (when needed) to ensure the correct diagnoses and procedure codes were used. This includes reviewing the medical records to ensure accuracy and that the medical records are correct and adding codes when needed to allow the coding to be as specific as possible (as long as the medical records justify the addition).
Able to use the medical coding system accurately and any of the systems available to us accurately.
Contacting third party payors in a timely manner to determine claim status professional claims.
Resolve denial instances from insurance companies to achieve maximum reimbursement for services provided.
Be able to answer/educate other staff on changes in codes/coding guidelines to ensure everyone is informed and correctly coding to the best of their ability.
Review account receivables for ageing (AR) reports and make appropriate collection calls on outstanding receivable balances for insurance companies and patient responsibility.
Work account receivable (AR) in claim status buckets by contacting insurance companies in a timely manner to determine claim status of professional claims.
Review and work credit balance to maintain accurate account balances.
Strong customer service by demonstrating compassion, concern, empathy, and ethics.
Answer patient and staff telephone inquiries pertaining to billing.
Responding to all forms of communication with proper terminology.
Reviewing past due accounts for potential bad debt by escalation to third party collection of write off.
Following all collection policies by working patient collection amounts.
Maintaining communication with manager and customer collections.
Collecting payments on unpaid patient balances.
Resolving denial instances for insurance companies with maximum reimbursement for Conifer Medical Center/ Evergreen Family Medicine.
Accurately posting insurance and patient payments in various forms.
Deploy, Maintain, and report on various programs.
Qualifications:
Must have strong computer skills including experience with utilizing fax machine, copier, printer, telephone, etc.
Must have minimum of High school education/ GED or equivalent.
CPC-A or higher certification is preferred.
Experience in customer service, patient billing, and collections within the medical industry is preferred.