Under supervision of the Business Office Manager, responsible for coordinating, verifying, distributing, and managing all billable services.
Researches all information needed to complete billing process including getting charge information from physicians utilizing any means necessary.
Enters patient information or verifies existing patient information as needed.
Codes any missing information about procedures performed or diagnosis on charge, utilizing ICD-9/ICD-10, CPT and/or HCPCS Codes.
Keys charge information into billing program if needed and produces billing to insurance, patients and/or third party payers.
Sends electronic claims batch and/or paper claims and works any rejections.
Works with other staff to follow up on accounts until at zero balance or turned over for collection according to billing policies.
Writes appeals for charges denied in error.
Assists with coding and error resolution.
Assists with answering the telephone and provides information as requested including assisting patients with account inquiries.
Maintains required billing records, reports and files.
Participates in educational activities, including attaining CEUs to maintain certifications.
Maintains strictest confidentiality.
Submits patient statements per policy.
Prepares deposits to send to bank for miscellaneous deposits received by the Business Office.
Prepares posting batches as needed to ensure complete and accurate posting from lock-box.
Posts insurance payments and/or adjustments to appropriate accounts using the Explanation of Benefits.
Posts patient payments to appropriate accounts.
Prepares write-off requests verifying they are in accordance with the write-off policy. Submits to the Business Office Manager or CBO Coordinator if over $500, otherwise writes off with the appropriate adjustment code.
Prepares collection requests verifying they are in accordance with the collection policy. Prepares paperwork for referral to collection agency. Assigns accounts to collection in system to write off balance with appropriate adjustment code and submits to Business Office Manager or CBO Coordinator for verification before sending to collection agency.
Prepares refund requests verifying they are in accordance with the refund policy. Submits refund request and supporting documentation to Business Office Manager or CBO Coordinator for approval and processing.
Performs other duties as assigned.
Wyoming Medical Center