About the role
Salary Range: $33.78 - $41.46 + applicable differentials
Essential Job Responsibilities
Achieving Results;
- Under the guidance of the Revenue Cycle Director, the Government and Commercial Billing Managers are tasked with billing various account types, encompassing HMOs, PPOs, Worker’s’ Compensation, Government Payers and Self-pay accounts. - Ensure all necessary documentation is present for billing patient accounts. - Coordinates with various insurance carriers to meet standard requirements, ensuring appropriate payment of claims and adherence to guidelines before billing. - Processes claims using the designated electronic billing system corresponding to the insurance plan, with any remaining claims billed in hardcopy to the relevant insurance carrier. - Collaborates with relevant personnel and hospital departments to ensure accurate diagnosis and procedure coding on claims. - Reviews past due accounts and associated documents to identify and access delinquency issues. - Conducts reviews of claims denials, identifies root causes, and takes necessary actions, including follow-ups and appeals in a timely manner.
Demonstrates Skills;
- Investigates reasons for claim denials to uncover any unique circumstances contributing to payment delays and communicates with relevant parties for follow-up, potentially seeking assistance from Payer Contracting, Case Management, and Health Information Management (HIM)/Coding departments. - Executes a comprehensive array of tasks, potentially rotating assignments or specializing in a particular area as needed. - Demonstrates proficiency in all computer systems essential for completing job responsibilities and comprehends the integration of information across all financial systems.
Planning and Coordinating;
- Responsible for daily claims processing and billing - Completes assigned work queues and handles daily incoming correspondence. - Participates in mandatory annual events and education sessions.
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