PFC II, Billing & Collections
Description:
Job Details
Patient Financial Service Building - Hondo, TX
Full Time
None
Days
Description
POSITION PURPOSE:
Processes claims electronically to all insurance carriers. Mails claims to Carriers when required. Works all billing vendor edits including Medicare Service Center and the daily unbilled reports.
KEY RESPONSIBILITIES:
Works all identified insurance requirement edits through the electronic billing system.
Communicates issues with patient access and facility ancillary departments.
Research required information and maintains pending follow up on a daily/weekly basis.
Transmits daily all electronic claims to the billing vendor to be sent directly to the insurance carriers.
Works electronic insurance rejects daily in order to retransmit with corrected information.
Works the rebills daily and/or weekly that are submitted to the billing department through the electronic billing system.
Work the Daily/weekly verifications that the insurance carriers received all electronic acknowledgements.
Submits required paper billing to insurance carriers daily and/or weekly.
Attach requested documentation to paper billing when required.
Maintain daily follow up with the facility late charge reports.
Late charges to be reviewed based on specific insurance payor requirements.
Submit adjustment requests to Medicaid through online automated system.
Work the Medicare 72 hour and Medicaid 24 hour reports to identify Compliance overlapping accounts.
Transfer charges when appropriate.
Work all related Medicare APC edits that appear on the bill alert reports and communicate with facility departments in order to resolve.
Enter notes in the collection system of actions taken.
Practice and adhere to the “Code of Conduct” philosophy.
Attend all required billing education classes.
Other duties as assigned by supervisor.
Qualifications
QUALIFICATIONS:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EDUCATION:
High school diploma or general education degree (GED); one year experience in medical patient financial services; one year related experience and/or training; or equivalent combination of education and experience.