Ability to perform billing functions for affiliate locations.
Provide communication and teaching to Billing/Account Specialists and Billing Records Technicians.
Answer questions and resolve problems related to billing operations.
Attend seminars/meetings and present material back to the CBO.
Prepare documents for secondary claim filing.
Identify potential discrepancies in claims payment processing.
Handle inquiries regarding claims/reports.
Work to resolve carrier denials for proper payment of claims.
Share responsibility through timely communication of identified problems to assure proper follow up is completed to expedite claims and ensure proper payment.
Work accounts receivable aging reports performing follow up in accordance with policies and procedures.
Obtain, verify and maintain customer demographics and insurance information for billing purposes (i.e. admission, financial/cost, CMN, etc.).
Make payment arrangements with clients, monitor compliance and take collection measures when necessary.
Generate and process statements and claim forms in an accurate as well as timely manner.
Maintain current knowledge of carrier specific requirements by attending workshops, reading newsletters, and acting as a liaison in carrier meetings.
Clear documentation of all communication related to accounts.
Demonstrate a professional image in dealing with the public, patients, families and vendors.
Review credit balance accounts on a monthly basis.
Identify and prepare appropriate paperwork when refunds are warranted, based on history of account and contractual agreements. Forward to Billing Team Lead for approval and processing.
Perform the review and confirmation of work orders prior to billing, by verifying accuracy of order and required documentation such as prescriptions, certificates of medical necessity, prior authorizations, diagnosis and procedure codes.
Responsible for the collection of out-of-pocket payments at the time of service per established protocol.
Meets measures as determined and required for job productivity and performance improvement.
Maintain regular and consistent attendance at work.
Behave in a manner consistent with Mission, Vision, Values and Expectations for Excellence.
Maintain compliance with OSHA, Accreditation Standards and Risk Management guidelines.
Maintain compliance with Personnel policies and procedures
Behave in a manner consistent with all Corporate Compliance policies and procedures.
Perform other duties as requested by Billing Reimbursement Manager to facilitate the smooth and effective operations of the organization.
Employee is responsible for completion of communication tasks and activities in a timely manner. This would include, but is not limited to: responding to email, voicemail or telephony messages, promptly, accurately, and professionally; attending staff meetings as scheduled or viewing videotapes of those meetings; asking questions of team members and supervisors when needing clarification about various day-to-day issues or patient needs; and reviewing employee communication pieces, to stay aware of UnityPoint at Home programs and initiatives.
High School or Vocational School graduate.
Strong interpersonal skills.
Ability to work independently or as part of a team.
Ability to understand and apply guidelines, policies and procedures
Proficient in Microsoft office software.
Previous medical office experience.
Familiar with billing codes i.e., HCPCS, Revenue, CPT Coding, Diagnosis Coding, etc.