Insurance Biller- 813051
Gerald Champion Regional Medical Center
Submits all clean claims to the appropriate insurance payer the same day as the claim is loaded into the Editor with the exception of weekends.
Reviews payer EOB’s but not limited to payment accuracy, patient liability, and appeal grievances if applicable.
Files appeals on denied claims and/or forwards to the Nurse Auditor for review if applicable
Maintain better than an 80% clean claim average.
Attach but not limited to the medical records, implant invoices, and itemized bill to the claim when applicable
Process incoming mail correspondence from the payers within 5 business days
Work assigned billing reports within 2 business days
Follow up with the insurance companies by phone and or web for the status of outstanding claims if applicable
Respond to patient inquiries regarding the status of the patient’s insurance within 2 business days
Submit newborn notifications to income support if applicable
Review/resolve the accounts on the Unbilled Report daily (accounts that are on hold and haven’t been processed by the editor).
Enter detailed notes explaining account activity in the Patient Accounts system
Take payments over the phone.
Print UB and 1500 hardcopy claims when required by the payer
Bill secondary claims before the timely filing deadline
Research late charges to determine the cause; inform your supervisor if they are a regular occurrence.
Handle incoming correspondence and inquiries on accounts.
Report trends/issues to Supervisor and the Director of Patient Financial Services
Follow up with all insurance companies within 30 days of billing if there is no payment on the account if applicable
Forward patient complaints regarding care to your supervisor for entry into the appropriate resolution pathway
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