Third Party Billing Clerk jobs in Coventry, RI

Job Summary:

Under the direction of the A/R Supervisor, the Third Party Analyst will maintain the management of Care New England accounts receivable. Responsible for following up on current, past due accounts, and secondary balances with third party payers on claims that are denied or unpaid beyond the contracted time frame. Assist supervisor with reporting, analyzing and trending of the accounts receivable. The Third Party Analyst functions as a billing liaison to patients, providers, and insurance carriers, internal and external customers to ensure appropriate reimbursement on claims.

Duties and Responsibilities:

Maintain accounts receivable by aged categories.

Communicate with insurance carriers, patients or Care New England internal and external staff to appropriately obtain reimbursement on claims.

Effectively utilizes reports to resolve assigned accounts within established time frame.

Accurately documents account history in appropriate computer systems within defined time frames in accordance with department policies and procedures.

Inform supervisor of denial trends and/or negative factors that impact the accounts receivable

Utilize Care New England procedures and policies when addressing charity care, community benefit discounts, contractual adjustments, other adjustments, and patient discounts.

Adhere to insurance and governmental guidelines to prevent denials and collection disruptions.

Demonstrates knowledge of accounts receivable payment policies and hospital contracts as they relate to billing, collection, follow-up, claim reimbursement, patient liability, and local, state and federal programs.

Review all third party credits and determine if adjustment, refund or recoup is warranted.

Handle and process all incoming phone calls, emails and mail correspondence from insurance and patients in a timely manner to ensure continuous collections.

Preserves and protects patients' rights to confidentiality.

Performs other related duties as requested.

Requirements:

High school degree required. Associates degree preferred.

Minimum of two years related experience in a health care environment or accounts receivable.

Knowledge of third party payers, medical terminology, word processing, statistical tools, and computer applications, including Excel highly desirable.

Must have excellent interpersonal, communication and typing skills, as well as demonstrate appropriate decision making/judgment skills when addressing the accounts receivable.