To submit and/or follow-up on all claims for HealthAlliance for multiple payors.
RESPONSIBILITIES
Demonstrates proven abilities to effectively process, analyze and resolve a multitude of billing issues on multiple payors.
Works independently. Makes sound decisions when necessary. Exhibits strong problem solving skills, as it relates to the billing and follow-up of claims.
Responsible for filing insurance claims for multiple third party payers. Addresses any edits pertaining to billing correctly and accurately; reporting repetitive edits to management for system correction. Makes the necessary corrections to accounts in Accounts Receivable system and electronic software.
Promotes/portrays a high level of professionalism, both technically and personally. Possesses strong worth ethic and exhibits optimism. Adheres to the departmental dress code policy and maintains a professional appearance and positive attitude.
Analyzes daily electronic billing reports for errors. Performs daily reconciliation of claim submission and receipt. Ensures that rejected claims are corrected and rebilled successfully.
Follows up on unpaid or denied claims for multiple payers. Actively works on assigned worklist incorporating high dollar report and denial report into the daily responsibilities. Proactively addresses problems and issues encountered in billing or follow-up in order to resolve accounts in a timely manner.
Stays informed on all rules and regulations governing billing and reimbursement of multiple 3rd party payors. Utilizes tools available including websites, payor meetings, educational seminars and provider reps.
Processes credit balances and issues refund requests where appropriate.
Promotes positive relationships among co-workers. Communicates effectively within the department and keeps management informed on key issues
Performs other duties as assigned.
QUALIFICATIONS/REQUIREMENTS
EXPERIENCE
One year minimum experience in a clerical capacity that includes working with large sums of cash preferred.