Job Description
Job Description
Salary : Job Summary :
Job Summary :
Performs electronic and manual billing and follow-up submission of claims to appropriate insurance carriers for various home care services.
Essential Duties and Responsibilities :
- Generates claims with appropriate modifiers, narratives, CPT / HCPC codes and submits claim to payers as required.
- Ensures that appropriate contractual pricing is attached to claims and that remaining balances, after payer adjudication are dropped to secondary payer and / or patient as appropriate.
- Responds to billing error documents, return-to-provider reports and denial letters. May notify relevant departments of missing or inaccurate documentation.
- Provides follow-up on clients’ accounts by responding to client questions and concerns regarding billing and resubmission of bills for payment.
May prepare split bills when necessary.
- Logs, tracks and answers all program requests and denials and responds to third-party requests when required.
- Reviews collection worksheets and initiates appropriate collection actions, including resubmission of claims.
- Assists in preparation and compilation of visit statistics, reconciliation of discharge summaries, admit reports and recorded visits.
- Prepares and maintains client billing files.
- Communicates with program staff to discuss billing issues when necessary. Resolves billing problems as required.
- Conducts insurance verifications when necessary to remedy billing issues .
- Performs other duties as assigned by supervisor.
Minimum Qualifications :
Qualifications include high school diploma or equivalent, with at least one year of experience in billing, reimbursement, credit, collections and / or medical terminology.
Must be proficient with computer-based data entry, word processing, and the operation of other office machines. Requires extensive use of telephone with appropriate interpersonal skills.
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