Qualifications:
Minimum 2-3 years of experience in medical billing.
Must be able to communicate effectively with physicians, patients, and the public, and be capable of establishing good working relationships with both internal and external customers.
High School Diploma/GED.
Preferred Qualifications:
Knowledge of computer systems, including experience with GE patient management system. Knowledge of physician billing processes, ICD-10, and CPT coding.
Essential Functions:
Reviews insurance denials and rejections to determine the next appropriate action steps and obtain the necessary information to resolve any outstanding denials/rejections.
Verifies patient demographic information and insurance eligibility, including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.
Verifies receipt of claim with insurance plans, determining the next appropriate action steps and timeliness of claims maximum reimbursement.
Researches all information needed to complete the billing process, including obtaining information from providers, ancillary services staff, and patients.
Obtains and attaches referrals/authorizations to appointments/charges.
Maintains productivity and accuracy metrics per department expectations and AEIOU Behavioral Standards.
Assumes full responsibility for reducing the accounts receivable of insurance balances by working through outstanding accounts.
Analyzes account for proper claims processing and payment posting through inquiries from patients or staff.
Identifies and communicates trends and/or potential issues to the management team.
Follows and maintains all HOPCo policies and procedures, including those specific to billing and the Revenue Cycle.
Equal Opportunity Employer:
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
