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Maintain a current knowledge of insurance carrier and / or state program claims filing policies and procedures
Verify patient demographics and financial coverage; update as needed
Research and verify patient and / or insurance company and / or state program refunds / recoupments
Adjust patients accounts to reflect changes in payment responsibility
Verify accuracy of information on paper medical claim forms and mail to selected insurance carriers and / or state programs
Research patient charges not automatically assigned to selected insurance carriers and / or state programs, make corrections and assign manually
Maintain patient accounts; give GHC program discounts and / or other adjustments as needed
Appeal service charges rejected by selected insurance carriers and / or state programs and resubmit amended claim forms
Process claims / vouchers as needed for insurance plans and / or state programs
Obtain pre-certifications, prior-authorizations, or referrals for special provider services as needed
Verify motor vehicle or accident information with patient's insurance carrier
Maintain work ques with claim errors
Assist insurance carriers and / or state programs to acquire supplemental patient information needed to process claims
Assist patients to understand fees for services and billing processes
Assist patients to make payment arrangements and find financial assistance
Assist outside providers and vendors to obtain physician billing information
Assist employees to understand policies and procedures related to billing matters
Communicate and support training issues with billing staff
Comply with all regulations related to confidentiality of patient information
Maintain and / or create new payor and plans as needed
Able to manage multiple priorities and manage stress appropriately
Communicates appropriately and clearly with a pleasant and professional manner to all
Demonstrates excellent judgment in handling situations not covered by written or verbal instructions
Demonstrates a commitment to the mission, core values, and goals of Waco Family Medicine and its healthcare delivery including the ability to deliver exceptional patient focus with quality, compassion, and respect
Maintain certifications and website passwords as applicable
Other Duties :
Assist in scheduling patient appointments
Process billing statements and balance notification letters to patients
Assist patients to make payments on owed balances
Provide follow-up on patient's payment arrangements
Assist with daily mail duties
Provide backup support for clerks and other billing staff as needed
Other duties as assigned by supervisor
Physical and Mental Requirements :
Visual and auditory accuracy
Shift length 8 hours
Indoor setting
Continuous use of computer, calculator
Long periods of sitting and walking
Frequent use of telephone
Frequent use of stepladder
Continuous repetitive grasping and manipulation of both hands
Continuous conversational communication
Occasional reaching, standing, squatting, bending, kneeling, twisting and climbing
Occasional carrying, lifting, pushing and pulling of up to 10 Lbs
Infrequent use of personal transportation
Working in a frequently noise environment
Continuously working in a tight area
Understand / carry out simple / detailed, oral / written instructions
Memorize and retain instructions
Read and interpret detailed specifications
Qualifications
Reports To : Director of Billing Services
Education : High School Diploma or Equivalent required, College Hours preferred
Skills : Computer literacy, knowledge of ICD-10 CM / CPT coding, medical office billing and collection practices, federal / state / local financial assistance programs, strong interpersonal, oral, and written communication skills, excellent telephone, and customer service skills.