Job Description

Job Location: Patient Financial Service Building - Hondo, TX 78861
Position Type: Full Time
Travel Percentage: None
Job Shift: DaysPOSITION 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.

QualificationsQUALIFICATIONS:
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.