[Hiring] Insurance Billing Representative @Northern Arizona Healthcare

Role Description

Responsible for two aspects of billing, collection, credit, payments, and/or reconciliations. Billing responsibilities include manual re-bills as well as electronic submission to payers. Follow-up includes telephone calls to payers and/or patients, as well as accessing payer websites, and resolving complex accounts with minimal or no assistance necessary.

Responsibilities

• Billing
  • Demonstrates knowledge of editing and submitting claims to insurance clearing house by electronic or paper submission.
  • Demonstrates knowledge of when to send a claim to the auditor or coder for corrections.
  • Reviews and makes corrections to rejected claims and resubmits to payers.
  • Open communication on Updates-CPT codes and ICD-10 codes, as needed. Works with Billing Manager to maximize revenue potential based for services and providers.
• Claim follow up
  • Corrects, edits and manages denied claims through work queues, correspondence and emails: May consist of Invalid CPT, Invalid DX, Missing Modifier, Bill another Carrier, Invalid Eligibility, Authorization/Referral, Documentation Required or Other open tasks requiring intervention.
  • Enters encounter notes, regarding rejections and follow up activities performed to enable others to review claim history on all encounters.
  • Performs account adjustments or write-offs as needed in accordance with the 'Write-Off' policy.
  • Handles internal communications with the health centers related to insurance billing and collections.
  • Requests medical records from health centers as requested by the contracted insurance plans.
  • Corresponds with and assists vendors involved with patient accounts.
• Compliance/Safety
  • Responsible for reporting any safety related incident in a timely fashion through the Midas/RDE tool; attends all safety related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner.
  • Maintains confidentiality of all department, patient, and billing matters.
  • Completes all company mandatory modules and required job specific training in the specified time frame.
  • Stays current and complies with state and federal regulations/statutes and company policies that impact the employees area of responsibility.

Qualifications

• High School Diploma or GED - Required
• Medical Insurance Billing/Collections - Preferred
• Medical/Hospital Billing - Preferred
• Knowledge of UB04 - Preferred
• Knowledge of Explanation of Benefits (EOB) - Preferred

Requirements

• Understanding of computers and competence in using computers and basic software programs.