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Full Job Description
With limited supervision, performs complex clerical and accounting functions for patient billing, including verification of invoice information, maintenance of third party billing records, and resolution of problems. Follows up on submitted claims and patient billing; resubmits claims or correct inaccuracies.
- Under direction, ensure that the activities of this position and relevant programs are consistent with the mission, vision and values of Catholic Charities, Diocese of Cleveland.
Follow all regulations and guidelines set by Medicare, state programs, HMO/PP and all other third party guarantors.
Process billable services to all third party reimbursable entities for payment.
Prepare, review and send monthly client self-pay statements
Enter information necessary for insurance claims such as client, insurance ID, diagnosis and treatment codes and provider information. Ensure claim information is complete and accurate.
Maintains supporting documentation files and current patient information.
Researches and responds by telephone and / or in writing to patient inquiries regarding billing issues and problems.
Monitors on a regular basis submitted claims; follows up on unpaid claims, and initiates dialogue with insurance
companies.
Resubmits claims to insurance companies on a regular basis.
Collect delinquent accounts by establishing payment arrangements with clients, monitor payments and also follow up with clients when/if payment lapses occur.
Reviews accounts for possible assignment to collections and makes recommendations to the Billing Manager, also prepares information for the collection agency.
Work with collection agencies and small claims court to collect on delinquent accounts, if necessary.
Develops and maintains a process for reviewing guarantor A/R balances as part of monthly close process. Makes recommendations for bad debt write-offs to Billing Manager or Director of Finance.
May receive and receipt cash items and third party reimbursements.
Participates in development of organization procedures and update of forms and manuals.
Participates in educational activities and attends monthly staff meetings.
Assists in development and communication for key areas to improve accuracy and understanding of processes.
May assist in the preparation and/or assembly of complex and/or confidential reports, annual budgets, proposals and other information as necessary.
May analyze, establish and maintain department file systems and recordkeeping systems, which may include confidential financial/client information to ensure maximum accountability.
Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations.
Frequent sitting, talking, listening/hearing;
Reading, writing and finger dexterity to manage correspondence, faxing, copying, answering phones, forms/documents, computer and client files required on a frequent basis;
Tasks require visual perception and discernment;
Organizing and coordinating schedules;
Analyzing and interpreting data;
Communicating with the public;
Frequent use of computer and telephone.
Combination of education and experience normally represented by a High School diploma or GED.
Working knowledge of medical billing systems preferred.
Five years of related work experience.
Knowledgeable on insurance and reimbursement process.
Familiarity with HIPAA privacy requirements for client/patient information.
Must have good oral, written and interpersonal communication skills.
Must be well organized, detail oriented and have the ability to maintain confidentiality.
Ability to show patience and courtesy when working with people.
Good telephone and client/patient relation skills.
Ability to work with diverse client population and community organizations.
Knowledge of Microsoft Office software