This position provides a close working relationship with patients, physicians, coworkers and insurance companies and their representatives to ensure proper coding, billing and collections for services rendered; Provides management of patient accounts, including maintenance and accurate financial and statistical records; Responsible for training physicians and staff on ICD-10 and documentation guidelines; Promotes and provides customer satisfaction and appropriateness of care of all assigned patients.
STATUS: Full Time (40 Hours)
LOCATION: United Memorial Medical Center – Chandler Building
Minimum Qualifications: Minimum 3 years’ experience with knowledge of insurance billings, EOBs, appeals and all aspects of patient accounts receivable. Extensive working knowledge of insurance companies and language involved. Position requires accuracy and ability to complete task in a fast paced environment.
Education/Training: High school diploma or GED certificate required, AAS in related field preferred, COSC/CPC preferred or willingness to certify.
Experience/Skills/Abilities: Excellent computer skills, Microsoft Office. Be capable of dealing tactfully and effectively with patients, employees, physicians, and attorneys.
1. Maintains established practice policies and procedures, objectives and customer service standards.
2. Verify benefits and eligibility with patient insurance coverage. Pre-certify, if required, any surgical procedures with patient insurance coverage. Discuss coverage benefits, expectations of payment and deposits required with patient. Billing of primary and secondary charges to insurance companies. Collect insurance information and enter data into computer program. Constantly checks for updates and managed care referrals for data entry. Complete individual physician surgical sheets as assigned.
3. Posting patient and insurance payments as received. Follow up with patients and insurance companies on past due balances. Reviewing patient accounts monthly to address bill messaging for patient statements. Checks own charges/payments for accuracy. Processes fee slips and payments per established protocols. Balances for the day. Performs bank deposit protocol and runs ends of day/end of month reports. When performing charge-out, collect co-pays, back balances.
4. Maintain first point of contact for all entities and agencies that wish to obtain medical services for injuries and illnesses covered by the patient’s workers’ compensation. Ensure that all necessary demographic and billing information is obtained and properly entered into the PMS. Fully understand the Medical Treatment Guidelines as published by the NYS WC board. Maintain First point of contact for iHCFA electronic billing and follow-up.
5. Advises patients about payment and insurance. Composes and types letters as required for patients. Daily closing functions as required by practice management software. Daily logs and assignment journals.
6. Responsible for reviewing the coding on all daily office visits. Reviews daily charge notes and codes appropriate CPT, ICD and HCPCS codes. Understands and abides by billing compliance guidelines. Understands Medicare/payer groups rules and regulations.
7. Performs other functions not listed here as requested by management.
Rochester Regional Health is an Equal Opportunity / Affirmative Action Employer. Minority/Female/Disability/Veteran