Job Details

Job Summary

Responsible for accurate and timely data entry of all practice charges and balancing of controls; data entry of all miscellaneous insurance payments, communication with insurance companies/patients and the timely follow-up of all outstanding claims with third party payers.

Responsibilities

Enter charges and patient payments from encounter forms and mail on a daily basis.

Check encounter forms for accurate IDC/CPT codes before charges are posted.  

Verify daily batches are all balanced to totals (cash, credit card, checks) and charges and correct as needed.

Process end of day procedures

Print HCFA forms for all paper claims to third party payers.

Transmit electronically, Medicaid Blue Cross and United Health Care claims.

Work audit trails correcting rejections and re-sending claims electronically.

Receive and process all electronic remittances.

Assist patients with account problems, insurance problems or questions.

Post all insurance and Medicaid payments and adjustments. Verify payments are in balance with checks.

Print delinquent reports and work old balances.  Call third party payers to determine status of claim, find a solution and resolve accounts.

Perform month end and year end processing 

Maintain system files. Verify that daily system back-up occurs .Print specialized computer reports.

Compose letters of appeal to insurance companies

Acts as a resource for front desk staff concerning computer operations, correct forms usage, etc.

Communicate with the Practice manager to inform of billing status issues on a daily basis.

Maintain patient schedule master file.

Order office supplies and cleaning products. Work credit balance report monthly.

Request patient or insurance refunds.

Perform other duties and tasks as assigned.

Education

High school diploma or equivalent required

Experience

Three years of medical billing or healthcare insurance experience in clerical or office work required, preferably in the medical field.

Licensures, Certifications, and/or Registries