Description
Summary:
Performs all functions related to the timely follow-up and collection of third party patient accounts, in accordance with State and Federal rules and regulations and hospital policy and procedure.
Responsibilities:
- Reviews reports from insurance companies/government payers for possibility of resubmission
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Resubmits, bills patient, or writes-off as appropriate
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Files appeals on rejected services within filing deadline
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Follows-up on unpaid third party accounts by telephone and/or tracer within time frames and guidelines set forth in hospital policies and procedures
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Prepares rebilling as necessary
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Reviews correspondence received from third party carriers, etc., and responds before insurance company deadlines
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Makes request for medical records when necessary
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Reviews payments on accounts for accuracy
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Contacts insurance carriers if payment is less than quoted benefits to resolve balance responsibility
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Calculates or recalculates contractual allowances and corrects as necessary
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Corrects Managed Care discounts, employee discounts, etc. as necessary after recalculating discount
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Documents all insurance activity in computer system
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Demonstrates competence to perform assigned responsibilities in a manner that meets the population-specific and developmental needs of members served by the department
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Appropriately adapts assigned assessment, treatment, and/or service methods to accommodate the unique physical, psychosocial, cultural, age specific and other developmental needs of each member served
Requirements:
Work Schedule:
8AM - 5PM Monday-Friday
Work Type:
Full Time