Responsible for billing, follow-up, and collection of accounts, while ensuring billing practices are ethical and compliant with government regulations and guidelines. Ideal candidate will be exceptionally detail-oriented, persistent, and an independent problem-solver, willing to work a problem to its successful conclusion.
Meets with clients and guarantors as necessary to discuss insurance coverage, co-payments, deductibles, and to collect appropriate up-front deposits.
Verify patient insurance eligibility and benefits
Perform prior authorizations
Submit electronic and paper claims to insurance providers
Downloads billing files as scheduled and demonstrates an understanding of billing systems.
Downloads and processes re-bills in a timely fashion, identifying billing errors readily to prevent duplicate denials.
Identifies any billing problems with certification dates.
Works with Providers and AK Medicaid to resolve any certification problems.
Posts all payments and corresponding adjustments accurately and in a timely manner.
Proactively handles all billing issues to get all bills paid timely and follows up on all given outstanding A/R.
Processes paper bills and edits properly per insurance requirements.
Communicates effectively with clients, vendors, and guarantors; tracks information regularly for required tasks.
Communicates effectively with other departments regarding missing information or to obtain correct data.
Performs other duties as assigned.
Qualifications EDUCATION/EXPERIENCE: High School Diploma or GED.
KNOWLEDGE/SKILLS:
Ability to perform assignments with minimal supervision;
Able to work independently, take the initiative to get information, and problem-solve.
Ability to review multiple details at a time and identify issues.
Ability to make sound, independent judgments based on scientific and/or ethical principles;
Capability of adapting to varying workloads and work assignments on a constant basis;
Effective comprehensive reading skills, strong communication skills, written and verbal.
Must have a working knowledge of computers.
MINIMUM REQUIREMENTS OF THE POSITION:
Must be able to complete new hire requirements such as State of Alaska Background Check.
Must be able to demonstrate special training, knowledge and skills specific to job and/or program within the first three (3) months of training.
Must complete all mandatory in-services annually.
PHYSICAL REQUIREMENTS: Requirements include, but are not limited to the ability to communicate effectively with employees; the ability to effectively utilize communication equipment; the physical agility to manage cleaning equipment; the ability to read and write.
Frequently utilize physical ability for standing or sitting for long periods of time.
Regularly utilize physical ability for speaking, hearing, and seeing with correction for close and distance vision, color discrimination, peripheral vision, depth perception and focusing ability. Speaking and hearing may be necessary for conversing with and assessing employees.
Must be able to concentrate amidst distractions; must be able to perform work of a repetitive nature.
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