BillerCollector Specialist
Central Louisiana Surgical Hospital, Alexandria, LA, United States
Benefits
401(k)
401(k) matching
Dental insurance
Health insurance
Paid time off
Vision insurance
Job Summary
This position generates insurance claims and patient statement billing in a timely and efficient manner in accordance with Facility policies. The position is responsible for working the accounts receivable to collect outstanding balances from insurance companies and patients, including processing all claim denials, appeals of improper payments, and resolution of credit balances. The role reviews financial obligations with patients and family members, may perform pre‑qualification of third‑party coverage for scheduled procedures, and participates in cross‑training for other Business Office positions.
Reports To
Business Office Manager
Classification
Non Exempt
Qualifications
High School graduate or equivalent.
Minimum of two years experience in a hospital or medical facility business office.
Automated billing system experience preferred.
Occupational Exposure
Office Environment
Responsibilities
Maintain standards to ensure systematic, consistent and timely filing of Medicare, Medicare HMO, and Blue Cross Blue Shield claims.
Ensure claims pass edits for correctness per payor requirements.
Ensure unbilled claims are reviewed for correctness.
Meet all standards set forth in Key Performance Indicators adopted by the Facility.
Maintain current information on claims adjudication and payment policies on all government intermediaries.
File secondary claims to appropriate insurers.
Assume other duties and responsibilities as necessary.
Maintain current information on claims adjudication and payment policies on all encountered third‑party payers and government intermediaries.
Maintain current information on correct and lawful practices in billing government and private payers for Prospective Payment System.
Monitor accounts receivable to identify billing errors and timely rebilling.
Follow‑up on past‑due accounts with patient or payers.
Report status of accounts receivable as requested.
Provide management reports to the Business Office Manager per protocol.
Assist with preparation and maintenance of Facility records and reports.
Answer patient and family member questions regarding financial responsibility and explain insurance requirements, referring questions to healthcare professionals when appropriate.
Communicate pertinent information from the physician, support staff, insurance companies, and other significant parties to the patient.
Report regularly to the Business Office Manager about the status of current projects or workflow.
Discuss financial obligations with patient or family member, explaining the fees and reimbursement process and responding to any patient inquiries.
Comply with facility Standards of Behavior and complete all required education assignments within the designated timeline.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job the employee is frequently required to sit, converse, and listen; use hands to touch, handle, or feel objects, tools or controls; and to reach with hands and arms. Specific vision abilities required by this job include close vision and the ability to adjust focus. The employee must be able to lift and/or carry over 20 pounds on a regular basis and be able to push/pull over 25 pounds on a regular basis. The employee must be able to stand and/or walk at least two hours per day.
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
#J-18808-Ljbffr
401(k)
401(k) matching
Dental insurance
Health insurance
Paid time off
Vision insurance
Job Summary
This position generates insurance claims and patient statement billing in a timely and efficient manner in accordance with Facility policies. The position is responsible for working the accounts receivable to collect outstanding balances from insurance companies and patients, including processing all claim denials, appeals of improper payments, and resolution of credit balances. The role reviews financial obligations with patients and family members, may perform pre‑qualification of third‑party coverage for scheduled procedures, and participates in cross‑training for other Business Office positions.
Reports To
Business Office Manager
Classification
Non Exempt
Qualifications
High School graduate or equivalent.
Minimum of two years experience in a hospital or medical facility business office.
Automated billing system experience preferred.
Occupational Exposure
Office Environment
Responsibilities
Maintain standards to ensure systematic, consistent and timely filing of Medicare, Medicare HMO, and Blue Cross Blue Shield claims.
Ensure claims pass edits for correctness per payor requirements.
Ensure unbilled claims are reviewed for correctness.
Meet all standards set forth in Key Performance Indicators adopted by the Facility.
Maintain current information on claims adjudication and payment policies on all government intermediaries.
File secondary claims to appropriate insurers.
Assume other duties and responsibilities as necessary.
Maintain current information on claims adjudication and payment policies on all encountered third‑party payers and government intermediaries.
Maintain current information on correct and lawful practices in billing government and private payers for Prospective Payment System.
Monitor accounts receivable to identify billing errors and timely rebilling.
Follow‑up on past‑due accounts with patient or payers.
Report status of accounts receivable as requested.
Provide management reports to the Business Office Manager per protocol.
Assist with preparation and maintenance of Facility records and reports.
Answer patient and family member questions regarding financial responsibility and explain insurance requirements, referring questions to healthcare professionals when appropriate.
Communicate pertinent information from the physician, support staff, insurance companies, and other significant parties to the patient.
Report regularly to the Business Office Manager about the status of current projects or workflow.
Discuss financial obligations with patient or family member, explaining the fees and reimbursement process and responding to any patient inquiries.
Comply with facility Standards of Behavior and complete all required education assignments within the designated timeline.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job the employee is frequently required to sit, converse, and listen; use hands to touch, handle, or feel objects, tools or controls; and to reach with hands and arms. Specific vision abilities required by this job include close vision and the ability to adjust focus. The employee must be able to lift and/or carry over 20 pounds on a regular basis and be able to push/pull over 25 pounds on a regular basis. The employee must be able to stand and/or walk at least two hours per day.
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
#J-18808-Ljbffr