ESSENTIAL FUNCTIONS:Call and status outstanding claims with third party payors.Review claims issues and make corrections as needed and rebill.Utilize claims clearing house to review and correct claims.
Resubmit electronically when available.Review explanation of benefits to ascertain that claim processed and paid correctly.Complete adjustment forms if any adjustments need to be made to an account and attach all supporting documentation.Manage daily productivity via patient accounting system and productivity reports.
Needs to maintain an average of 30-40 accounts worked per day minimum.Prorate patient accounts and monitor that balance due is in the correct financial class.Report an overview of the week to the BOD and participate in AR meetings.Gather and interpret data from system and understands appropriate course of action to take and initiates time-sensitive and strategic steps resulting in payment.Assist financial counselors as needed.Alert Financial Counselors and Business Office Director of all benefit eligibility matters that suggest or challenge reimbursement.OTHER FUNCTIONS:Perform other functions and tasks as assigned.Education/Experience/Skill Requirements:High school diploma or equivalent required.Three or more years’ prior admissions and or collections experience in a hospital setting required.Psychiatric experience preferred.Equal Opportunity Employer/Protected Veterans/Individuals with DisabilitiesThe contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.
However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.
41 CFR 60-1.35(c)