Posts payments, both electronically and manually, in a timely and accurate manner. This includes recognizing and correcting errors which may occur during the downloading of the payments. Consistently reaching goal of having 100% of remittances posted by the last day of each month.
Posts manual charges as needed, in an accurate and timely manner. This includes communicating with the provider if changes are needed in coding, reviewing the charges through the charge review work queue, and correcting and resubmitting the charges through the claim edit work queue to keep revenue flowing, as well as correcting clearinghouse issues. Consistently reaching goal of having 100% of claims posted and released by the 7th day of the month, for the previous month.
Follows up on partially paid or unpaid claims on a regular basis to accomplish the goal of having no more than 15% of unpaid claims over the age of 120 days. This includes accessing insurance websites, direct calling to insurance companies, contacting patients, writing appeals, and supplying requested documentation, authorizations, and/or referrals when needed.
Answers patient phone calls in a timely and professional manner and handles patient inquiries politely and accurately. Remembers that this is the "face of Bon Secours" to the patient.
Prepares refunds as needed for return to patients and insurance companies. Reviews accounts for transfer to collection agency when needed. Reviews statements for proper discounts to self pay patients.
Interacts effectively and professionally with office staff and providers to create teamwork which accomplishes our established goals.
Any other duties as assigned by the billing manager or supervisor, required for the smooth workflow of the revenue cycle.
At least five (5) years of experience in a medical office setting. Must be a Certified Professional Coder (or equivalent). Minimum of 3 or more years of hands-on coding experience with claims processing and/or experience in a medical office billing department. Specialty coding certification strongly recommended.
Requires strong skills in the following areas: Interpersonal communication skills, both verbal and written; problem identification and analysis.
Requires a high level of coding accuracy and attention to detail.
Comprehensive knowledge of the coding guidelines, regulatory requirements and payer-specific guidelines.
Past auditing experience and/or strong training background in coding and reimbursement.
Strong computer skills, including experience with Microsoft Office applications (Word, Excel, Access, PowerPoint, and Outlook) and practice management software is mandatory. Epic experience a plus.
Must be willing to travel to all BSMG practice locations as needed.
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Westchester Medical Center