Billing/Collections Specialist - Full-Time - APN- Physical Therapy - RO22

Billing

• Verifies patient billing information is correct prior to every claim submission.
• Works to resolve all identified insurance requirement edits through the electronic billing system; ensures submitted claims meet payer’s guidelines.
• Balances daily receipts list to cash, checks, and credit card payments received at the end of each day.
• Communicates issues to Director of Outpatient Therapy and Business Manager regarding problems with patient access and facility departments.
• Marks daily transmissions of all electronic claims to the clearing house and submits claims monthly.
• Works on electronic insurance rejects in order to retransmit with correct insurance information.
• Works on rebill requests from collection team.
• Verifies that all electronic acknowledgments were received by the insurance carriers.
• Sends required paper billing to insurance carriers with required documentation, including secondary claims.
• Attaches I-bills to paper billing when required.
• Reviews late charges based on specific insurance payer requirements. Submits adjustments as required.
• Enters notes in the patient accounting system on action taken.
• Adheres to state and federal billing guidelines and applies regulations in day-to-day billing practice.
• Adheres to HIPAA and PHI guidelines.
• Assists with all aspects of the Therapy Office including, registration, billing, collections, and cash posting.
• Assists with AR reviews on a weekly basis to identify problems/issues specific to payers and offer direction and resolution avenues to resolve reasons for non-payment or payment delays.
• Works with Patient Access Reps for all Therapy Offices ensuring that all patients with third party insurance coverage are verified, notified of any insurance limits, required deductibles, co-insurance amounts and their overall patient responsibility and monitors this is being done correctly.
• Interacts with HIM department as needed to ensure coding is completed timely.
• Notifies Director of Outpatient Therapy and/or Business Manager of any patient complaints in a timely manner.
• Assists with other duties as assigned by the Director of Outpatient Therapy or Business Manager.

Insurance Denials

• Aid in working insurance denials and refile denied claims as necessary.

Answering Phones

• Courteous to visitors, patients, and physicians’ offices.
• Responsible for discussing patient accounts/bills over the telephone if a patient calls regarding their statements.