About this role
PRIMARY DUTIES
- Maintain a current knowledge of insurance carrier and/or state program claims filing policies and procedures
- Verify patient demographics and financial coverage; update as needed
- Research and verify patient and/or insurance company and/or state program refunds/recoupments
- Adjust patients accounts to reflect changes in payment responsibility
- Verify accuracy of information on paper medical claim forms and mail to selected insurance carriers and/or state programs
- Research patient charges not automatically assigned to selected insurance carriers and/or state programs, make corrections and assign manually
- Maintain patient accounts; give GHC program discounts and/or other adjustments as needed
- Appeal service charges rejected by selected insurance carriers and/or state programs and resubmit amended claim forms
- Process claims/vouchers as needed for insurance plans and/or state programs
- Obtain pre-certifications, prior-authorizations, or referrals for special provider services as needed
- Verify motor vehicle or accident information with patients insurance carrier
- Maintain work ques with claim errors
- Assist insurance carriers and/or state programs to acquire supplemental patient information needed to process claims
- Assist patients to understand fees for services and billing processes
- Assist patients to make payment arrangements and find financial assistance
- Assist outside providers and vendors to obtain physician billing information
- Assist employees to understand policies and procedures related to billing matters
- Communicate and support training issues with billing staff
- Comply with all regulations related to confidentiality of patient information
- Maintain and/or create new payor and plans as needed
- Able to manage multiple priorities and manage stress appropriately
- Communicates appropriately and clearly with a pleasant and professional manner to all
- Demonstrates excellent judgment in handling situations not covered by written or verbal instructions
- Demonstrates a commitment to the mission, core values, and goals of Waco Family Medicine and its healthcare delivery including the ability to deliver exceptional patient focus with quality, compassion, and respect
- Maintain certifications and website passwords as applicable
OTHER DUTIES
- Assist in scheduling patient appointments
- Process billing statements and balance notification letters to patients
- Assist patients to make payments on owed balances
- Provide follow-up on patients payment arrangements
- Assist with daily mail duties
- Provide backup support for clerks and other billing staff as needed
- Other duties as assigned by supervisor
PHYSICAL AND MENTAL REQUIREMENTS:
- Visual and auditory accuracy
- Shift length – 8 hours
- Indoor setting
- Continuous use of computer, calculator
- Long periods of sitting and walking
- Frequent use of telephone
- Frequent use of stepladder
- Continuous repetitive grasping and manipulation of both hands
- Continuous conversational communication
- Occasional reaching, standing, squatting, bending, kneeling, twisting and climbing
- Occasional carrying, lifting, pushing and pulling of up to 10 Lbs
- Infrequent use of personal transportation
- Working in a frequently noise environment
- Continuously working in a tight area
- Understand/carry out simple/detailed, oral/written instructions
- Memorize and retain instructions
- Read and interpret detailed specifications.
Qualifications
REPORTS TO: Director of Billing Services
EDUCATION: High School Diploma or Equivalent required, College Hours preferred
SKILLS: Computer literacy, knowledge of ICD-10 CM/CPT coding, medical office billing and collection practices, federal/state/local financial assistance programs, strong interpersonal, oral, and written communication skills, excellent telephone, and customer service skills.