Accurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, to include but not limited to pre-admission, admission, pre-registration and registration functions.
Ensure all insurance requirements are met prior to patients' arrival and inform patients of their financial liability prior to arrival for services.
Arrange payment options with the patients and screens patients for government funding sources.
Obtain prior authorization/pre-certification for clinic procedures as required by insurance carriers as needed according to PRMO guidelines.
Obtain insurance verification and inform patients of their financial liability.
Arrange payment options for financially liable patients.
Pre-register patients with accurate patient demographics and financial data as needed.
Resolve insurnace claim denials/rejections.
Calculate and collect payments appropriately for all patients.
Resolve appropriate WQ edits.
Inform attendin physician of patient financial hardship.
Update billing system to reflect the current insurance status of the patient.
Assist with department coverage at the front desk, as needed.
Reconcile necessary blling and WQ issues.
Gather necessary information and documentation to support proper handling of billing inquiries and complaints.
Requirements
Work requires knowledge of basic grammar and mathematical principles normally required through a high school education, with some postsecondary education preferred.
Additional training or working knowledge of related business.
Two years experience working in hospital service access, clinical service access, physician office or billing and collections.
Or, an Associate's degree in a healthcare related field and one year of experience working with the public.
Or, a Bachelor's degree and one year of experience working with the public.
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