- Review patient's insurance coverage upon admission to determine coordination of benefits, eligibility, and other factors.
- Obtain and enter any authorizations for new patients that have coverage that requires it, as well as follow up on any expired authorizations/referrals for assigned clinics.
- Review remits, accounts, and other correspondence to determine patient responsibilities for billing purposes.
- Maintain records of patient billing cycle for each clinic to ensure all billing is completed according to policy and procedure.
- Properly document all follow up and steps taken in electronic system to ensure accounts are being followed up on and in a timely manner.
- Conduct month end processes and close clinics by reconciling treatment totals, reviewing monthly charges, resolving discrepancies, and reviewing other monthly reports.
- Review, enter, and coordinate updating current NDC codes being used at designated clinics.
- Ensure all claims go to payers via electronic clearing house, keying into portals, etc. once all charges have accurately been recorded onto the patient accounts.
- Review contracts both original and system loaded and coordinates with internal departments to ensure appropriate billing system resolutions.
- Review Medicare and other primary payments to ascertain which accounts need to have secondary claims submitted to other payers.
- Review correspondence and remits via cash management system to identify incorrect payments, inappropriate denials, or complete required adjustments. Follow up on incorrect postings, incorrect payments and/or denials, and complete work to resolve account.
- Contact insurance companies via telephone call to determine steps on accounts that require follow up due to lack of payment or incorrect reimbursement.
- Interpersonal skills/expectations include: Excellent communication skills.
- Organization skills/expectations include: Attention to detail is a must.
- Advanced skills in Microsoft Office software, particularly Microsoft Word and Excel.
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AR Specialist - Sacramento, United States - Dialysis Clinic, Inc.
Description
OverviewFounded in 1971, Dialysis Clinic, Inc. (DCI) remains the nation's largest non-profit dialysis provider. With a team of approximately 5,000 talented and caring employees serving across the United States, DCI provides care to nearly 15,000 patients on dialysis and 3,500 patients with chronic kidney disease. We offer a variety of services including in-center hemodialysis, home hemodialysis, and peritoneal dialysis (PD). Each position within DCI, from billers to administrators to nursing staff, contributes toward the goal of providing excellent patient care. Our staff has helped DCI achieve the lowest mortality and hospitalization rates among large dialysis providers for the past 13 years in a row.
The AR Specialist will provide continual and accurate documentation regarding eligibility, authorization, and other insurance coverage information for assigned patients by staying in contact with clinical staff and social workers, calling insurance companies and providing online verification. Responsible for reviewing all primary payments and denials for accuracy as well as sending out initial claims, corrected claims and appeals.
This position is for the California / NM region.
Responsibilities
Competencies
