Description

Under general supervision, performs a number of clerical task to efficiently hand the PPO Financial classes collections follow up to secure payment on billed claims.

Core Competencies

Reviews and processes the out-patient correspondence from the insurance carriers for the PPO financial classes. Identifies and resolves problem issues independently. Verifies insurance eligibility and authorization as needed. Manages staff to oversee Explanation of Benefits are returned to staff within 1 week of request. Promotes positive customer relations. Utilizes hospital computer system to update, adjust, and process accurate patient accounts. Stays informed of updated insurance requirements and reimbursement practices. Assists with training of new staff members. Answers and handles a heavy volume of incoming calls.

Education

Additional Information

2 years experience in Business Office

Experience

Number of Years Experience

1 Biller/collection experience in medical office or hospital.

Additional Information

Ability to use 10-key adding machine. Knowledge of admitting procedures/requirements. Knowledge of insurance billing procedures and requirements. One year experience in hospital business office. Knowledge of PPO/HMO/Capitation reimbursement and contractual discounts.

License / Certification Requirements