Billing Representative for Infusion - Perelman Center for Advanced Medicine, FT

Responsibilities:  

1. Ongoing support and analysis of routine financial functions of the department, including billing, Accounts receivable, aging reports, and productivity. Assures consistent quality and cost effectiveness of daily operations through coordination with physicians, patients and process assessment.

2. Responsible for accuracy of all submitted charges for physicians on a daily basis. Post provider services utilizing CPT, HCPCS, ICD9/10, with applicable modifiers. 

3. Ongoing financial support and analysis of reimbursement issues and insurance contracts. Assures compliance with payer and Regulatory agencies. Develop an understanding of Medicare, Medicaid, intermediary and 3rd party pay rules and regulations as applied to Provider services to facilitate account resolution.  Receives, identifies and applies payments from all sources to patient accounts. Researches and resolves over/under payments from all sources. Receives, identifies and applies payments from all sources on a daily basis. Researches, initiates and posts refunds when required. Recommends patient accounts for write-offs, health assistance, or referral to outside Collection agency.

4.  Enter insurance data, prepare and submit claims to all insurance companies and patients, receive remittance lists from insurance companies, identify payments and denials, apply payments to patient records for all sources, and investigate and follow up on denied claims. Enters insurance information to patient accounts for billing of fees for Physician Billing Programs.  Enters insurance information as required, as evidenced in remittance lists from Insurance companies or patient payment. Prepares, submits, and follows up bills to all payors. Prepares, submits bills and follows up self pay accounts for noncovered services, denials and co-payments. Bills all payors within scheduled time frame in accordance with insurance regulations and requirements. Resolves all open balances. Processes claim rejections as received. Researches exceptions, problems, Incorrect data/information, and open balances.  Bills patients' accounts for non-covered services and co-payments and follows up as required, via telephone calls or written correspondence, as documented on patients' records. Ensures accurate and timely communication of medical reports to primary and or referring physicians in established time frame.  Create billing error reports and check for accuracy, correct all errors for billing.  Receives, identifies and applies payments from all sources to patient accounts. Researches and resolves over/under payments from all sources. Receives, identifies and applies payments from all sources on a daily basis. Researches, initiates and posts refunds when required. ◦ Coordinates with hospital cashier, cash being posted to physician billing programs. Recommends patient accounts for write-offs, health assistance, or referral to outside Collection agency.

Education or Equivalent Experience:  H.S. Diploma/GED And Expertise in reimbursement analysis(Required). Familiarity with computer data entry, coding, and billing procedures (Required). Work experience in healthcare (Required). Work experience in healthcare, preferably in a medical office setting (Preferred)