Billing Representative

About US: SGS is a New Jersey headquartered end-to-end Professional Services firm servicing a diverse Fortune clientele. SGS is a Equal Opportunity Employer and prides itself as a employee oriented organization that considers an ensemble of all employee satisfaction elements crucial to organizational and employee growth. We offer a complete range of benefit packages to our employees which includes but is not limited to paid vacations, holidays, personal days, medical insurance, 401K savings plan, life insurance, disability insurance and many other attractive benefits.

Job Title: Billing Representative

Duration: 3 Months(temp to perm) (direct offer)

Location: Eden Prairie, MN

Job Description:

• Performs follow-up on outstanding Certificates of Medical Necessity (CMNs), prescriptions and processes renewal CMNs/prescriptions through the use of suspended billing reports. Maintains and monitors follow up system to confirm that action takes place per Apria "best practices". 

• Performs timely follow-up on renewal authorizations to maintain reimbursement activity. 

• Contacts patient to gain involvement in problematic situations.  

• Elevates aged prescriptions to manager for decision and resolution. 

• Evaluates all completed CMNs/prescriptions/authorizations to ensure that the appropriate information has been obtained to allow for reimbursement as well as compliance with applicable standards and regulations. 

• Enters CMNs/prescription information into computer once the prescriptions are completed and returned from the physicians.  

• Documents all account activity on system. May perform internal quality audits to ensure that all necessary documentation is included in each patient file. 

• Processes, reviews and mails prescription and/or CMNs to physicians for signature. 

• Provides feedback on errors identified to the appropriate supervisor through the use of the ENF process or other accepted method.  

• Researches diagnosis and insurance benefits to receive proper reimbursement.  

• Assists in obtaining authorization for reimbursement for some accounts.     

• Requests adjustments on accounts and recommends necessary changes to supervisor. 

• Complies with and adheres to all regulatory compliance areas, policies and procedures and "best practices". 

• Performs other related duties as directed by supervisor.

 Himanshu Ojha

6096518972