Billing and Reimbursement Specialist-Patient Financial Services*Days 40hrs/wk
- Minimum high school diploma or GED, with two years experience working in an accredited hospital or physician office preferred
- EPIC or Revenue Cycle Certification a plus
- Ability to work independently with minimal supervision
- Good oral and written communication skills.
- Proficiency with computer functions, including ability to use automated systems for third party billing and insurance follow up.
- Professional, business-like appearance and demeanor
- Recognizes and reports problems, errors and discrepancies to management
- Shares information with co-workers
- Ability to contribute to team efforts
- Ability to assist with training of new employees as needed
- Works closely with Hospital and/or Physician office staff to assure correct information is obtained for billing purposes.
- Reviews claims daily, prior to submission to payers, for accuracy utilizing electronic billing software
- Reviews and takes action on claims returned by payers, whether denied or underpaid
- Ability to post payments and reconcile vouchers according to department standard workplan
- Responsible to validate the payments and adjustments made on accounts are correct
- Maintains daily work queues according to payer requirements, including late charges/credits, multiple visits in one day, 3-day rule, changes in insurance coverage, and claim errors
- Files claims to payers in a timely manner to assure prompt reimbursement
- Prepares Medicare Bad Debts following CMS guidelines
- Ability to analyze reports from third party vendors for self pay balances.
- Responsible for quality and productivity standards established by management
- Complete knowledge of payer guidelines, including utilization of payer websites and other tools
- Other duties as assigned.
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