Job Number: 11368
- 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
- Ability to lead and create motivated workers