Ensures that patients are eligible for grants/insurances by assisting assigned clinic(s) with verification of insurance and grant patient eligibility on a timely basis and ensuring appropriate documentation exists in the electronic health record.
Verifies patient insurance eligibility and re-verify weekly or monthly based on state requirements. Ensure billing episodes are changed promptly for applicable patients.
Verifies patient eligibility for grant funding and re-verifies as required by grant program. Maintain good supporting documentation for audit purposes. Ensures billing episode is accurate.
Obtains treatment authorizations when needed from Medicaid or other programs in a timely manner; regularly updates Methasoft with correct billing episodes and authorizations.
Assists Program Director and Revenue Cycle in preparing and submitting patient refund requests and answering any related questions.
Communicates with patients to obtain the required information in order for Revenue Cycle to submit claims timely.
Communicates with clinic staff concerning patient inquiries related to initial billing and third party insurance matters.
Ensures patient insurance information is collected and accurately inputted into UDS vendor system for billing purposes.
Participates in regular Revenue Cycle update calls, assist in disseminating information within
assigned clinic(s) such as changes in payors, and provide or obtain answers to clinic personnel and patient questions.
updated AOB's as frequently as required.
Works collaboratively with Program Director(s), Revenue Cycle, and patients to address growing credit balances.
Revenue Cycle guidelines.
(Scope of the person's authority, including a list of jobs that report to this job).
(To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the competencies (minimum knowledge, skill, and ability) required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions).
Education/Licensure/Certification: High school diploma, GED, or equivalent education required.
Associates degree or higher preferred.
HIPAA. Proficiency in Microsoft Excel or Google Sheets. Basic Mathematics skills and revenue cycle/insurance terminology.
Experience Required: 5 years healthcare revenue cycle (e.g.; verification, claims follow-up, billing, etc.) experience. Additional patient financial service experience and/or collections experience is preferred.
Skill and Ability: Ability to accurately verify and re-verify patient insurance
eligibility. Proficiency in patient access. Ability to reconcile patient accounts. Ability to effectively explain patient insurance benefits to them. Excellent interpersonal skills (oral and written) and ability to work effectively with clinical personnel. Attention to detail, solid organizational skills, and ability to work independently. Highest level of confidentiality, discretion and integrity.