ESSENTIAL FUNCTIONS
- Reviewing claims and chart audits for completion prior to
- Review for appropriate CPT and ICD10 coding based on insurer requirements and coding guidelines before sending to the Certified Coding Specialist.
- Review of patient demographics (address, telephone #, guarantor changes, etc.) and insurance (certificate #, new primary or secondary coverage, etc.) for accuracy and completeness
- Review patient benefits and prepare medical estimates to be mailed to patients prior to surgery. Be prepared to answer patient questions that concern the estimate.
- Ensure provider information is correct
- Ensure that claim is completed and submitted within 48-hours after a complete chart audit and fully coded claim is received and implant invoice is attached as appropriate
- Once claims have been processed by the insurer, resolve any claim rejections or denials
- Posting of all payments received from the insurer(s) you are assigned
- Review all ERAs by line item to ensure patient balances are correct, the correct contractual adjustments have been done according to contracts, and the claims are in the correct status within the practice management system
- Patient accounts containing credit balances need to be applied to outstanding patient balances, or refunded to the insurer or patient based on how the credit was created
- Run weekly statements and post all patient balances
- Answer patient Billing questions and setup payment plans as applicable
- Manage the Collections process
- Work closely with the ASC Scheduler and Administrative Assistant in correcting booking forms, insurance issues, proper consents, implant invoice issues and any other ASC issue that pertains to the billing process.
- Review and maintenance of the insurance aging analysis for the insurer(s) you are assigned to include running and preparing financial reports for Finance.
JOB REQUIREMENTS
- High school diploma or GED required
- Certified Professional Coder preferred
- One to three years of accounts receivable experience (preferably in Health Care)
- Knowledge of accounts receivable practices and medical billing office procedures
- Knowledge of insurance reimbursement procedures and practices
- Ability to work effectively with co-workers and independently
- Ability to communicate effectively and clearly
- Must be able to work quickly and accurately
- Ability to maintain the confidentiality of patient information in accordance with company policy & procedure, and HIPAA regulations.
- Proficiency in Microsoft Office suite (Word, Excel, Outlook, and PowerPoint) is required as well as the ability to quickly learn and retain knowledge of how to use the electronic medical record.
- Proficiency with Windows based computer applications
- Ability to work autonomously and collaboratively with team members, including cross coverage to achieve the overall objectives of the department and organization
- Ability to demonstrate and uphold InterMed’s Values
SCHEDULE
Monday through Friday, 40 hours per week
InterMed is an equal opportunity workplace and prohibits discrimination or harassment of any kind. We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, gender identity and/or expression, sexual orientation, marital status, disability, veteran status, or any other basis protected by applicable federal, state or local law.
Qualifications