About this role
Job Summary
- Identifies status on unpaid 3rd party claims in a timely manner.
- Uses most effective tools to obtain status so that effectiveness and productivity are maximized.
- Communicates payment expectations and removes payers stall tactics in a firm but professional manner.
- Reports problem accounts and/or consistent slow payers to management and provides examples.
- Involves the patient and/or insured to obtain information needed by payers to process the claim.
- Conducts three-way calls between patients and payers to address obstacles in getting claims processed.
- Obtains, or assists in obtaining, any additional documentation needed by a payer to process a claim.
- Works with their billing partner to identify trends in billing errors, so the edits can be developed to increase clean claim rate.
- Accurately and thoroughly documents all pertinent events regarding the account.
- Demonstrates and encourages team behavior and exceptional patient/guest experiences.
- Upholds and promotes patient safety and quality.
Qualifications
Education
High school diploma required or equivalent.
Experience
3 years of hospital business office or physician office preferred.
Additional Skills/Abilities
Must be proficient in Microsoft Office Suite of products. Knowledge of ICD, CPT, revenue codes and modifiers is required. Familiarity with payer website and portals is preferred.