• Medicare Biller/Medicare Collector - Patient Accounts - 813025

    Job ID
    2018-1929
    Category
    Accounting/Finance
    Job Location
    US-NM-Alamogordo
  • Overview

    Demonstrates knowledge and skills necessary to provide services based on the physical, psychosocial, educational, safety, and other related criteria appropriate population in his/her assigned area

    Maintains required core competencies.

    Complies with set Policies and Procedures (i.e. name tag, dress code, parking, smoking, etc.)           

    Submits all clean claims to the appropriate insurance payer the same day the claim is loaded into the Editor with the exception of weekends and Holidays

    Reviews payer EOB’s but not limited to payment accuracy, patient liability, updating the financial class, notify commercial biller to submit secondary or tertiary insurance, and appeal grievance.

    Files appeals on denied claims and/or forwards to the Nurse Auditor for review/appeal

    Enter denials on the Denial Log

    Enter the USPS tracking number in the Patient Accounts system

    Enter the USPS delivered date in the Patient Accounts system

    Contact payer to ensure an appeal was received

    Maintain better than an 80% clean claim average.

    Attach but not limited to the medical records, implant invoice, and itemized bill to the claim before billing if applicable

    Process incoming mail correspondence from the payers within 3 business days

    Work assigned billing reports within 2 business days

    Work the rejection report daily to resolve problem accounts

    Follow up with the payer via phone and/or the website for the status of outstanding claims

    Respond to patient inquiries within 2 business days

    Respond to interdepartmental inquiries within 2 business days

    Respond to payer requests within 2 business days

    Respond to emails within 2 business days

    Submit newborn notifications if applicable

    Review/resolve the accounts on the Unbilled Report daily (accounts that are on hold and haven’t been processed by the editor).

    Enter detailed notes explaining account activity in the Patient Accounts system

    Process payments over the phone if applicable

    Print UB and 1500 hardcopy claims when required by the payer

    Submit primary, secondary and tertiary claims before the timely filing deadline

    Responsibilities

    Bill Medicare and Medicare HMO claims to the appropriate payer within the timely filing deadline. Maintain a clean claim submission rate of 80%. Work assigned billing reports timely. Ensure Medicare HMO claims are submitted to the correct billing address. Attach the necessary documentation to the claim for reimbursement

    Qualifications

    High School diploma or equivalent. Current American Heart – HeartSaver or Basic Life Support (BLS) card.  Prefer two (2) years of hospital or physician practice billing and/or collections experience. Able to work high volume accounts for resolution.  Working knowledge of computers and calculators desired.  Possess the ability to work with internal and external customers.

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