Performs follow up and collects on insurance balances, including governmental payors and workcomp, through the use of various systems and reports.
- 1-3 years’ experience
- High School Diploma or GED
- Minimum of 1 year claims billing experience in a healthcare setting
- Work denials and zero pay Explanation of Benefits and Remittance Advices to determine liability and appropriate action to ensure reimbursement.
- Maintain payor AR days through effective collection, account resolution, and proper monitoring of receivables. Document all transactions in the patient account system.
- Process correspondence, EOB's, RA's, system reminders, and interoffice mail in a timely manner with no more than a five day backlog. Identify payment and denial trends for payors and address them promptly.
- Updates/revises standard work processes regularly, ensuring they are current. Actively contributes to continual process improvements.
- Submits corrected claims as needed to payors.
- Identifies denials and submits timely appeals ensuring all documentation needed (including medical records) to support the appeal is submitted then reflecting accounts have been prorated accordingly.
- Maintain active communication with payors until account is paid/denied, or balance becomes the patient's responsibility.
- Monitor various payor systems to ensure suspended/pended claims are resolved in a timely manner, ensuring that they do not "drop" from the system. Follow up timely.
- Run weekly and monthly reports, including Aged Trial Balance, to effectively monitor accounts receivable.
- Provides back up to peers as needed and performs all other duties as assigned.
Location: Exeter Hospital · EH-Patient Accounts-ACASA
Schedule: full time, Day Shift, Monday thru Friday 8am-4:30pm