Essential Duties and Responsibilities

Evaluates and accounts for demographic and financial data for Accounts Receivable for professional medical services by performing the following duties:

Customer Service

• Answer calls in a professional and friendly manner.
• Completes necessary duties to resolve the account. Duties may include printing a bill, making a phone call, etc.
• Interviews caller to assess the situation, resolving problems quickly and accurately.
• Keeps accurate record of all phone inquiries.

Posting Patient Data and Charges

• Enters alphabetic and numeric data from source documents into the computer following format display.
  on screen, and enters necessary codes.
• Verifies documentation and coding using CPT and ICD-9 correct coding standards.
• Verifies accuracy of data entered, including reviewing error reports to make necessary corrections.
• Keeps record of work completed.
• Files or routes source documents after entry.
• Assists with related special projects, as required.

Accounts Receivable

• Records payments to customers’ accounts and maintains accounts receivable records.
• Files bank lock box receipts.
• Researches and processes refunds, bad checks, no pays (deductibles), and inadequate insurance payments, following up on instances where payment appears to be incorrect.
• Forwards the remaining balance on account to the appropriate next payer.
• Processes credit card payments weekly.
• Balancing individual daily postings to report from system.

Billing Duties

• Gathers and submits claims per noted schedule. Prints secondary claims and other claims that need to be printed.
• Logs and tracks claims through the whole claims processing cycle; gathering, submission, errors from ECP edits, fixing errors, errors and reception from Carriers.
• Performs follow-up with insurance Carriers per noted schedule. Contacts Carrier to assure payment is being made, resolves issues prohibiting payment, and escalates any unresolved issues to Billing Manager.
• Gathers and submits appropriate accounts to agency. Tracks batches with agency to ensure timely processing.
• Assists with related special projects, as required.

Core Skills Needed For All Positions  |  View