We Offer the following services
• Assist in meeting cash collection goals by reviewing, completing, and submitting appropriate documentation based on payer requirements. Knowledge of third party and insurance companies operating procedures, regulations and billing requirements, i.e. Commercial, Medicare, Medicaid etc.
• Perform billing, follow-up collection functions for third parties, resolving issues that impact or delay claims payment. Update data regarding changes and modifications in plan benefits and other contract information relevant to the billing or claims follow-up and collection process.
• Serve as support staff for various departments and external payers by developing positive relationships with managed care organizations, outside agencies, and clinical areas within the organization. Review and respond to correspondence and inquires generated by third party payers. Provide medical records, copies and other pertinent information to the appropriate sources. Work collaboratively to facilitate the insurance billing and collection process to improve overall cash collection.
• Work exception and rejection work queues and review EOB’S for correct contract payment.
• Monitor the status of denials, appeals, and claim errors by using folders/work queues and conducting routine, periodic follow-up on previously researched claims items. Monitor, review and suggest revisions or updates to existing forms, documents and processes required to facilitate timely billing and collections. Prepare and send written appeals, when necessary, with appropriate documentation.
• Ensure completeness of claims by following national, local, and internal billing requirements promoting prompt and accurate submission and payment. Maintain awareness of current regulations.
• Support overall Revenue Cycle processes to achieve established targets and goals, including the completion of special/specific assigned projects and other duties including the completion of special/specific assigned projects and other duties/tasks as assigned.
• Knowledge of medical terminology and ICD-10 beneficial, including professional and institutional billing CMS 1500 and UB04 Billing Forms, EOB’s, claims, coding and charges are required Follows-up on all assigned accounts from within the billing system in accordance with pre-established goals.