Job Purpose: The Billing & Collections Representative ensures the billing and claims processing life cycle remain in compliance with all pertinent coding, documentation and privacy guidelines. Responsible for timely billing and collections for assigned clinic, from weekly claims filing to collecting insurance payments and any unpaid patient liability amount.
Minimum Requirements:
Education & Training: High School diploma or GED equivalent.
Required Licenses/Certifications: None.
Work Experience: A minimum of 5 years of billing experience with medical billing protocols and health care coding guidelines.
Essential Job Responsibilities:
Demonstrates respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment.- Completes claims submission on a weekly basis for assigned clinic.
- Handles all account correspondence for assigned clinic. Direct patient contact for past due balance, payment plans, or to collect coinsurance or private pay amounts.
- Communicate with clinic on medical necessity issues.
- Meets with patients/representatives to produce financial summaries and arranges payment methods/arrangements.
- Generates and monitors charge rejection reports daily and works with clinical areas to resolve rejections, so that all revenue is posted for each patient visit/procedure.
- Follows up with insurance carriers on unpaid claims. Completes and files reconsideration requests to carriers with additional documentation or corrections.
- Performs account reconciliations and generates monthly billing information from various sources to create invoices and statements.
- Maintains established policies and procedures, objectives, quality assurance programs and safety standards.
- Participates in educational programs and in service meetings
- Performs other duties as assigned