-Has thorough knowledge of managed care contracts, current payor rates, understanding of terms and conditions, as well as Federal and State requirements.
-Interprets Explanation of Benefits (EOBs) and Electronic Admitt ance Advices (ERAs) to ensure proper payment as well asassist and educate patients and colleagues with understanding of benefit plans.
May review for applicable cash rates, special rates, applicable professional and employee discounts.
-May process bankruptcy and deceased patient accounts.
-Performs other duties as assigned.
Required Skills & Experience:
-One year of previous hospital business experience, or equivalent required or strong background in customer service.
-Basic experience with insurance plans, hospital reimbursement methodology, and/or ICD10 and CPT coding.
Required Education:
-High school diploma or equivalent required.