Full job description

This position is responsible for maintaining a timely revenue cycle and ensures accurate payment for goods and services according to contracted rates and/or payor fee schedules. Also responsible for maintaining patient confidentiality and function within the guidelines of HIPAA.

Job Duties:

Accounts Receivable:

• Collect on accounts by sending bills or following up on bills with payers via phone, email, fax, mail, or websites.
• Investigate and resolve customer inquiries regarding charges.
• Monitor patient account details for non-payments, delayed payments, and other irregularities.
• Communicate with customers regarding insurance, payments, and invoices.

Authorization and Confirmation:

• Collaborates with internal & external customers to provide status updates & coordinate appeals on denied authorization.
• Resolves pending revenue by reconciling approved authorizations and pending charges.
• Ensure orders will bill correctly to insurance.

Data Support:

• Responsible for the daily claims submissions/printing for all eligible/ready status claims
• Resolves all claim rejections in a timely manner to guarantee submission within the timely filing requirements of the payers.

Unbilled Revenue:

• Analyze documentation required for billing services and ensure compliance to payer requirements.
• Resolve pending revenue by reconciling received documentation and pending charges.
• Requests authorization from state Medicaid programs.
• Maintains and updates physician databases to ensure accurate delivery of billing documentation and communications with physician offices.
• Completes accurate documentation of authorization request and follow up activities on each account.