Insurance Billing Clerk na Ohio County Healthcare

Description

• Managing the billing and collections of Emergency Room physicians’ professional claims for the hospital. 

• Assist in filing insurance claims, determining write offs, and resolving coding issues. 

• Meeting monthly collection goals by maintaining aged AR balances greater than 90 days old at under 12% for ER physicians’ professional claims for all payers, excluding Medicare. 

• Reviewing all accounts on remittances to ensure balances are correct in CPSI and payment was properly posted. 

• Following up daily to resolve denied and non-covered claims/services by calling insurance companies, using payer websites, and working with provider representatives to have claims reprocessed. 

• Filing disputes and appeals, when necessary, with supporting documentation. 

• Utilizing provider portal websites to check eligibility, claim status, authorization information, member COB files, etc. 

• Reviewing errors on rejected accounts in our billing software (TruBridge RCM), correcting errors on claims before submitting to the payer. 

• Reviewing and resolving claims in Denial Management work queues in billing software (TruBridge RCM). 

• Working with Payer Representatives to problem solve ongoing issues and stay educated on any updates from the payer. 

• Ensuring that correct rates are being paid by payers according to contracts and professional fee schedules. 

• Billing secondary ER physicians’ professional claims either electronically or by paper claim submission. 

• Working a quarterly credit balance report to resolve credits on accounts. 

• Contacting patients to resolve coverage or billing concerns and updating across all accounts and systems. 

• Hospice billing duties:  Registering new and recurring hospice patient accounts into the CPSI system. 

• Hospice billing duties: Keying notice of elections for hospice patients to Medicare. 

• Hospice billing duties: Maintaining clean claims for hospice accounts and ensuring payment is collected and is correct.  

• Adding new and updating provider profiles in the CPSI system.  Adding physician numbers and all appropriate provider information into the physician tables. 

• Participating in educational activities and staff meetings when necessary. 

• Maintaining confidentiality and adheres to all hospital policies, including HIPPA guidelines. 

• Other duties as assigned. 

Qualifications

Preferred experience in an office setting with excellent work ethic skills. Prefer experience in medical office billing/precertification but not necessary.  Must have computer skills necessary to use Word, Excel and CPSI and ECW core system. Must have excellent customer service skills, i.e telephone, interpersonal, written.