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Billing Representative
Confirms insurance coverage. and verify if authorization have been obtained for scheduled procedures.
Determines financial responsibility for services to be provided. Notifies appropriate department/physician practices of any services requested and/or referred that are not authorized by insurance.Communicates with patients and appropriate department/physician practices regarding financial responsibility and insurance coverage issues following department specific guidelines. Responsible for reviewing and processes all correspondence.
Maintains detailed documentation in the patient account record of all billing activities. Maintains documentation of claims processed as part of the daily claim’s reconciliation process. Assures timely filing of original and corrected claims to prevent write-offs.
Prepares and completes claims for commercial insurance companies, third party organizations and/or government or self-payers. Researches, analyzes, and reconciles Medicare/Medicaid billing and reimbursement practices.
Consults with appropriate parties to resolve unbilled claims. Reviews recent accounts for proper billing practices and reimbursement.
Education:
High school diploma or GED required. Minimum one (1) year healthcare medical billing experience preferred.
Certified Patient Financial Services Specialist Preferred
- Ability to organize and establish day-to-day priorities while using critical thinking skills in all aspects of the job.
- Must be able to multitask while remaining professional, focused, composed and positive.
- Excellent customer service skills
- Displays integrity, friendliness, and compassion.
- Must be able to establish an appropriate and effective rapport with others.
- Demonstrates flexibility
- Takes initiative
- Able to work in a fast-paced environment
- Embrace new opportunities to grow both personally and professionally.
- Effective critical thinking and problem-solving skills.
- Proficient with various Microsoft Office products (Word and Excel).
- Strong organizational skills.
- Effective interpersonal skills.
- Ability to take and follow direction in a positive and appropriate manner.
- Ability to work as part of a team and independently.
- Must be able to demonstrate effective and appropriate written and oral communication skills.
- Must be able to speak, read, write and follow instructions in English
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