- Trends weekly productivity, Billing WIP, Follow-up WIP and agings.
- Attends weekly billing staff meetings
- Identifies payor & billing issues
- Participates in a positive & constructive manner
- Addresses and follows up on any client call or concern by next business day.
- Reviews bills and related information for accuracy and reasonableness of charges
- Submits bills to payers electronically if possible, otherwise paper
- Submits monthly self-pay statements to clients
- Stays current with third party contractual agreements and regulations to apply requirements for accurate billing and to make recommendations for system changes as needed
- Maintains zero billing WIP
- Calls payers for status on accounts on work list
- Records appropriately detailed notes in the Systoc system
- Takes appropriate action to resolve claims, i.e., the rep would proceed to complete any and all steps to have the claim paid. Including and not limited to; re-file claim, send notes, make corrections to the claim information, call employer, call patient, etc.
- Writes appeal letters
- Communicates with supervisor at Business Health and at payers
- Calculates expected reimbursement on accounts if necessary
- Holds payers responsible to contract terms and fee schedules
- Completes work list with the activity code, tickle date, phone number
- Demonstrates ability to work with high volume of outgoing calls associated with collection of accounts
- Demonstrates adequate, appropriate, and professional levels of communication with insurance company representatives, team members, supervisors, and managers.
- Establishes relationship with payer contacts
- Ensures timely turnaround of internal requests (EOBs, medical records) through effective follow-up
- Performs due diligence on all collection efforts
- Ensures expected reimbursement is secured
- Elevates serious barriers to claim resolution to appropriate management
- Assists other follow-up reps when necessary, as determined by manager, work with billing staff to identify and resolve billing issues and develop standard billing practices
- Maintains zero follow-up WIP
- High school diploma or equivalent
- Medical billing experience as acquired in a physician office setting.
- PC Skills, including Word and Excel.
- Customer Service Skills
- Excellent Communication Skills
- Knowledge of workers compensation and third-party billing rules and regulations
- One-year experience in physician billing and collections or equivalent education
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Follow Up and Billing Rep - Edgewood, United States - St. Elizabeth HealthCare
Description
Communication/Trending:
Billing Responsibilities:
Follow-Up Responsibilities:
Education, Credentials, Licenses:
Specialized Knowledge:
Kind and Length of Experience:
FLSA Status:
Non-Exempt
Right Career. Right Here. If you're looking for the right careers in healthcare, the right place to be is at St. Elizabeth. Join us, and you'll take pride in the level of care we offer our community and dis
