Position Summary: Performs a variety of clerical duties involved in collecting balances due and recording payments to accounts. Answers inquiries from patients regarding account charges, insurance payments and balances due. Code and post claims daily, post personal/insurance payments, Assist patients and insurance carriers. Gather proper insurance information to create clean claims.
Responsibilities:
- Reviews and corrects pending claims or bills; and prepares claims or bills for electronic or paper submission.
- Sorts and enters patient and/or payor payments, charges, diagnosis and accident information to appropriate accounts; processes explanation of benefits (EOB) and remittance advices (R/A) by posting payment and contractual adjustment; and makes proper financial adjustments to accounts.
- Runs and reviews daily reports of aging accounts receivables and collection work lists; contacts insurance companies on outstanding accounts; documents conversation and correspondence regarding accounts
- Receives and processes mail by responding to patient and/or payor requests; documents interaction with patient and/or payor; and receives telephone inquiries from patients, payors or internal customer service representatives.
- Maintain strict confidentiality.
- Transmit insurance claims, post insurance payments, separate combined payments and forward to appropriate clinic.
- Performs tasks for patient accounts such as; answering telephones, setting up financial agreements, updating demographics, posting patient’s payments.
- Research denials, unpaid claims, and aging report.
- Provide problem resolution for patients and insurance companies.
- Prepare requested billing documentation needed by the patient and/or insurance carriers.
- Prepare deposit for both rural health clinics.
- Update insurance information, verify coverage and benefits, alert the front desk of amount to collect from patient being seen that day.
- Schedule office visits as needed.
- Review/research documentation to code claims for both rural health clinics and send the claims to the insurance carrier in timely manner following proper coding guidelines.
- Maintaining compliance standards and accuracy.
- Conduct chart audit with compliance officer quarterly.
- Print off claims that payers did not receive.
- Match EOBs Balance and make deposits for clinics.
- Post payments to accounts.
- Research payments to make sure insurance payments are posted correctly to accounts, follow up with insurance companies to check on the status of claims, or denials Work follow up work ques and claim edit work ques.
- Make sure insurance information, registration information is correct on the claim.
Qualifications:
Required:
- High school diploma or equivalent is required.
Preferred:
- Satisfactory performance and one year experience
- One year of working in healthcare office setting
- Previous insurance or bookkeeping experience
- Certified Professional Biller
Infection Control: Initial and Ongoing training in dealing with infection control. Trainings could include but are not limited to, blood borne pathogens, bodily fluids and bio hazardous materials as it applies to your daily work environment.
Patient Interaction: Periodic
HIPAA: This position will have access to the following Protected Health Information in order to carry out the duties related to their position at Hays Medical Center based on the following criteria:
Primary – required (routine) to do the job;
Secondary – required for the job, but mostly be exception; and
None – no approved access
Description of Information
Primary:
Patient Demographic Information (information used to identify a person): Name, Date of Birth, Address, Race, Marital Status, Religion
Clinical Information (information that describes a patient’s health status): Diagnosis, Reports/Medical Notes, Test Results, Problem List, Procedures, History and Physical
Coding Information (clinical information that is in (alpha) numeric format): ICD-9 Codes, Rev Codes, CPT Codes
Financial Information/Insurance (information related to insurance, billing and payment): Billing Information, Payer Name, Payer ID, Account Balances, Plan Elements Covered, Payment Information, Payment Rates
HaysMed is an Equal Opportunity Employer.
