Schedule: Day Shift. 40 hours weekly. 8:00am – 5:00pm
Type additional details specific to position and/or department.
About the Position
This position is responsible for assisting staff with billing and collections questions, workflows and serving as a ‘subject matter expert’ in these areas for all payors. This position may at times be assigned special projects to ensure timely completion. The Lead will assist as the ‘first line of defense’ for one-on-one assistance to staff including answering process questions resolving system issues. The Lead position will also participate in the on-going education of staff based on system issues and payor specific guidelines/rules
Overview of Responsibilities
Assist with follow-up on accounts with insurance payors to avoid timely filing losses, using telephone, faxes, Internet, or other methods.
Verifies insurance coverage by investigation or interview.
Ensure no assigned insurance balance goes beyond filing deadlines.
Engage Revenue Cycle management when a claim is approaching the timely filing limit and staff is unsure how to get it paid or unable to get a response from the insurance/other responsible party.
Pay attention to the work around them and offer assistance when needed.
Assist with billing claims to ensure payment is received.
Work on special projects or assist staff on vacation/illness to complete assigned accounts.
Communicate with departments to resolve billing errors and edits.
Communicate with Manager and staff to resolve billing errors and edits.
Update insurance information for claims to be resubmitted when needed.
Take a lead role in identifying potential problems and suggesting solutions as new billing techniques or software are introduced.
Lead problem-solving initiatives when issues are identified.
Process modifications to the patient’s financial information, such as adding/deleting charges, special research, or reviewing reimbursement corrections.
Follow compliance with all laws, regulations, and guidelines, with emphasis on fraud, waste, and abuse prevention.
Perform other duties and projects as assigned to support department goals.
Actively participate in area and department meetings.
Attend other meetings as requested.
This list of duties and responsibilities is not intended to be all-inclusive and can be expanded to include other duties or responsibilities that management deems necessary.
Education & Experience
Education Required: High School Diploma or GED.
Experience Preferred: 2 years’ experience in medical billing or insurance with knowledge of government medical programs such as Medicare and Medicaid.