PAR II Billing Float

Job Details

Description

Job Duties
Insurance and Patient Collections and Posting Specialist Assist

• Accurately assists with posting of incoming mail payments and denials into the billing and information system.
• Assist in follow up and appealing accounts over 45 days (working denials).
• Communicates with Administrator/Physician any problems with accounts in a timely manner.
• Documents effective notes and updates tasks in the EPM/EHR system.
• Understands basic payer contracts, particularly fee schedules and notifies manager of any underpayments or incorrect denials.
• Assist with clearinghouse claims activity and notates any claim trends or issues with management.

OB Pre-Certification, Surgery, and Procedure Assist

• Assist with verification of benefits through the patient’s insurance company to include primary, secondary, tertiary or coordination of benefits regarding copayments and deductibles.
• Assist with notification to patients scheduled payments for uncovered services, co-insurance and deductibles.
• Assist with Pre-certify patients with insurance company for delivery at the appropriate hospital. Maintain and update patient information as it changes, billing out as appropriate.
• Reconfirm eligibility at 36 weeks for all OB patients. Notify appropriate physician of any inconsistencies or of any terminations of coverage.
• Assist in notification to insurance specialist of OB patients who have transferred care or are no longer an OB patient and determine billing codes in order to charge antepartum.
• Plans and coordinates surgical cases with hospital, anesthesiologist, physician, and assisting physician.
• Checks all documents prior to surgery and ensures completion of these documents to include notations to account of quotes and call details
• Assists with daily procedure schedules to ensure benefits are obtained and patient is expected to pay for services prior to visit.
• Assists with add on procedures to ensure they are covered and/or patient is informed of responsibility prior to obtaining services.
• Collects expected allowed amount deductibles and coinsurance as they apply prior to surgical and ob deadlines.
• Reviews completed surgery and delivery charges by obtaining all required information prior to posting; charges billed out based on current CPT & ICD9 guidelines.
• Protects and maintains patient’s right to privacy, safety, and confidentiality.
• Routinely checks EDD report and surgery schedule for timely posting.

Other duties include, but are not limited to:

• Assist with the daily mail log balancing for Synergy, certified mail tracking and logging.
• Assist with maintaining mail room to include stocking, assist with troubleshooting of copy, fax, mail machines, and ensure maintained filing room organization.
• Answer patient billing inquiries, assist check-out personnel in their attempts to collect as needed.
• Answers all forms of communication with co-workers, and review/respond to billing/insurance inquiries on a daily and consistent basis (to include email, teams, telephone, etc) in a timely and professional manner.

Qualifications

Skills

Preferred
Microsoft Excel
Novice

Planning/Organizing Skills
Novice

Patient Billing
Novice

Interpersonal Skills
Novice

Computer/Tech Literacy
Novice

Communication Skills
Novice

Auditing Skills
Novice

Analytical Skills
Novice

Adaptability Skills
Novice

Behaviors

Preferred
Team Player: Works well as a member of a group

Dedicated: Devoted to a task or purpose with loyalty or integrity

Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well

Motivations

Preferred
Self-Starter: Inspired to perform without outside help

Flexibility: Inspired to perform well when granted the ability to set your own schedule and goals

Experience

Required
At least 1 year experience with medical patient billing

Job Type: Full-time