Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.
Manages new accounts, on a daily basis, by contacting payer to determine if the account has been received and/or if additional information is required. Assigns follow-up dates in accordance with follow-up guidelines.
Account resolution of all self-pay accounts including self-pay after insurance.
Manages new credit balance accounts every day and prepares adjustments or refunds to zero the account balance
Works all accounts listed in the Follow-Up cue, on a daily basis to promote collection of accounts. This will include telephoning the payer or identifying the claim on the payers’ Internet location.
Manages entire account inventory on a timely basis to promote payment and resolution of all accounts prior to ninety days from date of billing.
Answers incoming telephone call from patients who call with questions/information regarding their bills
Responds appropriately to incoming mail from patients or payers regarding their assigned accounts
Processes incoming hard copy explanation of benefits and reacts appropriately to resolve the accounts.
Records accurate and definitive notes in the electronic account file that depict the current status of account, issues with account and anticipated date of resolution.
Escalates account management to manager when extraordinary issues arise.
Obtains and records “Promise to Pay” amounts on a daily basis that are consistent with the cash collection goals of the department
Assigns a status codes to each worked account to enable account tracking, statistical data gathering and audit activities.
Identifies work unit issues and participates in solutions and problem solving by working with manager and staff members.
Attends staff meeting, in-house training and attends classes pertaining to Federal and State billing regulations as well as Compliance Issues and Guidelines when requested
Performs other job related tasks as assigned by Supervisor
Knowledge of computer based claims management
Strong windows knowledge, keyboarding skills, knowledge of database system and experience with internet applications
Able to operate basic office equipment i.e. copiers, fax machines and calculators
Must have an understanding of medical terminology
Requires strong customer service and problem solving skills
Requires the ability to handle multiple projects/tasks at the same time
Able to prioritize workload and possess good time management skills
Ability interpret contracts, billing regulations and complex claim requirements