Billing Representative for Infusion - Perelman Center for Advanced Medicine, FT

Responsibilities

• Ongoing support and analysis of routine financial functions of the department, including billing, Accounts receivable, aging reports, and productivity.
• Affirms consistent quality and cost effectiveness of daily operations through coordination with physicians, patients, and process assessment.
• Responsible for accuracy of all submitted charges for physicians on a daily basis.
• Post provider services utilizing CPT, HCPCS, ICD9/10, with applicable modifiers.
• Ongoing financial support and analysis of reimbursement issues and insurance contracts.
• Affirms compliance with payer and Regulatory agencies.
• Develops an understanding of Medicare, Medicaid, intermediary and 3rd party pay rules and regulations as applied to Provider services to facilitate account resolution.
• Receives, identifies, and applies payments from all sources to patient accounts.
• Researches and resolves over/under payments from all sources.
• Receives, identifies, and applies payments from all sources on a daily basis.
• Researches, initiates, and posts refunds when required.
• Recommends patient accounts for write-offs, health assistance, or referral to outside Collection agency.
• Enters insurance information to patient accounts for billing of fees for Physician Billing Programs.
• Enters insurance information as required, as evidenced in remittance lists from Insurance companies or patient payment.
• Prepares, submits, and follows up bills to all payors.
• Prepares, submits bills and follows up self pay accounts for noncovered services, denials, and co-payments.
• Bills all payors within scheduled time frame in accordance with insurance regulations and requirements.
• Resolves all open balances.
• Processes claim rejections as received.
• Researches exceptions, problems, Incorrect data/information, and open balances.
• Bills patients' accounts for non-covered services and co-payments and follows up as required, via telephone calls or written correspondence, as documented on patients' records.
• Ensures accurate and timely communication of medical reports to primary and or referring physicians in established time frame.
• Create billing error reports and check for accuracy, correct all errors for billing.
• Receives, identifies, and applies payments from all sources to patient accounts.
• Researches and resolves over/under payments from all sources.
• Receives, identifies, and applies payments from all sources on a daily basis.
• Researches, initiates, and posts refunds when required.
• Captures and processes claims for insurance companies.
• Coordinates with hospital cashier, cash being posted to physician billing programs.
• Recommends patient accounts for write-offs, health assistance, or referral to outside Collection agency.

Qualifications

• H.S. Diploma/GED
• Expertise in reimbursement analysis
• Familiarity with computer data entry, coding, and billing procedures
• Work experience in healthcare