Handles the complete processing of patient accounts with third-party carriers from start to finish, including billing claims electronically or on paper, supplying additional information needed for claim adjudication, and answering patient and insurance company questions.
Major responsibilities
- Submit primary insurance claims to all carriers using the electronic claims terminal or hard copy claims.
- Review accounts pending payment from insurance companies and provide additional information as needed.
- Validate patient information to support accurate billing and follow-up activities.
- Apply adjustments and write-offs according to policy and procedure to maintain accurate account balances and statements.
- Maintain a suspense file for accounts needing additional documentation for eligibility determination prior to billing.
- Receive incoming calls from patients and insurance companies regarding open accounts and provide courteous, helpful responses.
- Perform other duties as assigned.
Requirements & Qualifications
Education
- High school diploma or equivalent required.
Experience
- 2 years of experience with electronic hospital billing or collections in a medical field required.
- 1 year of experience with personal computer software and other office equipment required.
- 1 year of medical terminology experience and familiarity with CPT, ICD-10, and HCPCS codes preferred.
Knowledge and skills
- Proficiency in reading, writing, and speaking English.
- Knowledge of third-party claim adjudication, including Medicare, Medicaid, Tricare, commercial insurance, and managed care.
- Must pass departmental training tests on calculating reimbursement, UB-04, Patient Account Terms, and System Navigation with a score of 75% or higher.
- Excellent verbal and written communication skills.
- Strong analytical ability and accurate mathematical calculation skills.
Physical requirements
- Near visual acuity.
- Motor coordination and finger dexterity for repetitive computer and office equipment tasks.
- Ability to lift up to 25 pounds.
- Ability to talk and receive information by telephone.
Location
North Carolina, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
3 weeks ago
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