Responsible for follow up of insurance to include: claims submitted, appeal processes and inquiries; monthly accounts receivable reports to ensure timely and maximum reimbursement from assigned insurance carriers.
- Field patient and insurance calls regarding patient account receivables.
- Audit patient accounts for accuracy regarding charges, payments, demographics, insurance information and filing to ensure contractual agreements are being met.
- Request adjustments, write-off, payment, refunds/recoups, and transfers when appropriate.
- Work insurance aging reports, review claims status, patient eligibility, accuracy of account information and modify as needed to ensure proper and timely payment while maintaining A/R aging per company guidelines to maximize remibursement.
- Submit patient claims, paper and electronic, after corrections have been made or when rebilling is needed. Create appeal letters to submit to insurance carrier for timely payments.
- Review and reply (as needed) to all insurance correspondence, including assigned carrier newsletters and guidelines as well as maintain a working knowledge of assigned carrier newsletters and guidelines as well as maintain a working knowledge of assigned carrier website.
- Maintain current knowledge of insurance guidelines through newsletters and websites.
- Assist with demographics/charge entry and capture of all hospital charges.
- Work in all areas of the department during peak times, vacations, illnesses, etc.