• Responsible for verification and interpretation of insurance benefits.
• Prepare and review all billing forms to ensure accuracy and completeness for claims submission to insurance carriers.
• Process claims electronically or hard copy with 100 accuracy and mail claims to insurance carriers timely.
• Enter documentation and adjustments through computer system to maintain a correct account balance.
• Review charge summaries on each patient bill that is produced and identify discrepancies with 100 accuracy.
• Consistently apply appropriate procedures to prevent accounts from becoming delinquent or remaining unbilled.
• Initiate appropriate follow-up and collection calls.
• Review remittance advice statements for payments and adjustments on a daily basis and initiate appropriate data entry for patient charge or account discrepancy on review.
• Identify denial /pending pay issues and investigate, resolve to secure reimbursement.

Additional Duties Depending on Experience

• Monitor and report on key metrics such as cash collections, AR days outstanding, unbilled claims, denials, daily census, etc. in conjunction with the CFO.
• Responsible for the Patient Accounting Month-End Close Processes.
• Maintain effective communication with the leadership team to ensure that all third party compliance guidelines are met.
• Work closely with Utilization Review and Admissions staff to ensure proper authorization of patient insurance coverage.
• May include managing and directing subordinate staff to identify goals and objectives.
• Data Entry