Performs all functions related to the timely follow-up and collection of third party patient accounts, in accordance with State and Federal rules and regulations and hospital policy and procedure.
Responsibilities:
Reviews reports from insurance companies/government payers for possibility of resubmission
Resubmits, bills patient, or writes-off as appropriate
Files appeals on rejected services within filing deadline
Follows-up on unpaid third party accounts by telephone and/or tracer within time frames and guidelines set forth in hospital policies and procedures
Prepares rebilling as necessary
Reviews correspondence received from third party carriers, etc
, and responds before insurance company deadlines
Makes request for medical records when necessary
Reviews payments on accounts for accuracy
Contacts insurance carriers if payment is less than quoted benefits to resolve balance responsibility
Calculates or recalculates contractual allowances and corrects as necessary
Corrects Managed Care discounts, employee discounts, etc. as necessary after recalculating discount
Documents all insurance activity in computer system
Demonstrates competence to perform assigned responsibilities in a manner that meets the population-specific and developmental needs of members served by the department
Appropriately adapts assigned assessment, treatment, and/or service methods to accommodate the unique physical, psychosocial, cultural, age specific and other developmental needs of each member served
Requirements:
High School Diploma
Work Schedule:
8AM - 5PM Monday-Friday
Work Type:
Full Time
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