**MINIMUM 2 YRS EXP REQUIRED***
POSITION SUMMARY
Works under the supervision of the Billing and Collection Supervisor. Analyzes and interprets Managed Care contract language, terms, conditions, and responsibility matrices. Performs telephone and written follow-up with patients, insurance companies, third party payers, worker’s compensation payers, medical groups, outside hospitals and physician’s offices to ensure timely payments. Has a strong understanding of CMS regulations, Managed Care and insurance company payment principles, rules, and regulations. Is knowledgeable with the use of appropriate HCPCS, CPT 4 codes, Modifiers, ICD9 and ICD10 codes. Understands the billing and payment follow up time limits set forth by Medicare, payer contracts and has the knowledge of insurance billing rules and regulations. Has the ability to utilize multiple hospital systems.
EDUCATION/EXPERIENCE/TRAINING
• High school graduate
• Previous experience working in an acute hospital patient account setting
• Minimum of 2 years’ experience in hospital collections
• Customer service experience.
DUTIES AND RESPONSIBILITIES
1. Safeguards and preserves the confidentiality of patient’s protected health information in accordance with State and Federal (HIPAA) regulatory requirements, hospital, and departmental policies.
2. Ensures a safe patient environment and adherence to safety practices per policy.
3. With consideration to age, employee utilizes the approved process to resolve biophysical, psychological, educational, and environmental needs of patient/significant other when administering care.