Insurance Billing Professional

Responsibilities

Review insurance denials and rejections to determine appropriate next action steps and obtain necessary information to resolve any outstanding denials/rejections.

Verify patient demographic information and insurance eligibility including coordination of benefits; update and confirm as necessary to allow processing of claims to insurance plans.

Verify receipt of claim with insurance plans, determining the next appropriate action steps and timeliness of claims maximum reimbursement.

Research all information needed to complete billing process including obtaining information from providers, ancillary services staff, and patients.

Obtain and attach referrals/authorizations to appointments/charges.

Maintain productivity and accuracy metrics per department expectations and AEIOU Behavioral Standards.

Take full responsibility of reducing the accounts receivable insurance balances by working through outstanding accounts.

Analyze accounts for proper claims processing and payment posting through inquiries from patients or staff.

Identify and communicate trends and/or potential issues to management team.

Follow and maintain all HOPCo policies and procedures, including those specific to billing and the Revenue Cycle.

Demonstrate current competencies for job position.

Education

High school diploma or GED

Experience

Minimum two to three years of experience in medical billing. Must be able to communicate effectively with physicians, patients and the public and be capable of establishing good working relationships with both internal and external customers.

Knowledge

Knowledge of the physician billing processes, ICD-10 and CPT coding.

Knowledge of computer systems. Experience with Athena preferred.

Knowledge of insurance plan websites and portals.

Advanced computer knowledge, including Window based programs.

Skills

Skill in customer service.

Skill in using computer programs and applications including Microsoft Excel, Microsoft Word and Outlook.

Skill in establishing good working relationships with both internal and external customers.

Abilities

Ability to multitask in a fast-paced environment. Must be detailed oriented with strong organizational skills.

Ability to understand patient demographic information and determine insurance eligibility.

Ability to work independently and demonstrate the ability to analyze data.

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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