USA Health Systems
Medical Billing & Collection Specialist
USA Health Systems, Mobile, Alabama, United States, 36624
Overview
USA Health is Transforming Medicine along the Gulf Coast to care for the unique needs of our community. USA Health is changing how medical care, education and research impact the health of people who live in Mobile and the surrounding area. Our team of doctors, advanced care providers, nurses, therapists and researchers provide the region's most advanced medicine at multiple facilities, campuses, clinics and classrooms. We offer patients convenient access to innovative treatments and advancements that improve the health and overall wellbeing of our community. Responsibilities
Answer telephone and provide information on patient statements/correspondence with the appropriate follow-up. Assist walk-in customers with questions regarding billing; field complaints and disputes to the proper personnel. Manage encounters daily, review and monitor in-house encounters, and process incoming correspondences. Complete encounters in work queues weekly; set contact terms on encounters to meet minimum payment requirements; follow up on delinquent formal payment plans. Prepare encounters for audits, document and charge with audit results; research self-pay encounters for insurance coverage and forward information to the proper area for encounter updates. Prepare encounters for recommendation of refunds; verify employment and check probate court for property and estate claims. Review discharged patients for correctness of patient and insurance information and necessary forms; recommend encounters for suit or placement with an outside collection agency or attorney. Review Mobile County Record for court action involving patient encounters; submit encounters for estate filing. Maintain a thorough and current knowledge of billing requirements and reimbursement methodologies for all assigned coverages; maintain reports and lists as required by management. Collect and reconcile encounters for assigned coverage; respond timely and accurately to written billing inquiries from patients and/or insurance companies. Make necessary demographic and insurance additions, deletions, and changes to the system guarantor/patient information; utilize online systems for follow-up and reconciliation of encounters. Work audit reports received from insurance companies; maintain encounter integrity by ensuring that insurance pro-ration, adjustments and transactions are accurate. Reconcile encounters from insurance Explanation of Benefits; monitor insurance payments and allowances for proper reimbursement per contract; reconcile credit balances. Check work items and email daily and take appropriate action; identify solutions to work-related problems and issues. Request medical records as needed and follow up on receipt; communicate with physicians, patients, families and USA personnel in person and via telephone. Communicate work-related problems and issues to supervisor or management staff; maintain accurate and complete records by documenting all follow-up activities with insurance company or patient clearly and concisely on the patient encounter. Maintain proper filing of patient and insurance correspondence including Explanation of Benefits and insurance denials; maintain contact file folders on all patients with established contract terms. Adhere to hospital policies including confidentiality; maintain regular and prompt attendance; work schedule as defined and overtime as required; perform related duties as required. Qualifications
High school diploma or equivalent and one year of medical billing and/or collections experience in a medical office setting. Hospital billing and claim follow-up experience relating to commercial, UHC and Medicare Advantage plans is highly preferred.
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USA Health is Transforming Medicine along the Gulf Coast to care for the unique needs of our community. USA Health is changing how medical care, education and research impact the health of people who live in Mobile and the surrounding area. Our team of doctors, advanced care providers, nurses, therapists and researchers provide the region's most advanced medicine at multiple facilities, campuses, clinics and classrooms. We offer patients convenient access to innovative treatments and advancements that improve the health and overall wellbeing of our community. Responsibilities
Answer telephone and provide information on patient statements/correspondence with the appropriate follow-up. Assist walk-in customers with questions regarding billing; field complaints and disputes to the proper personnel. Manage encounters daily, review and monitor in-house encounters, and process incoming correspondences. Complete encounters in work queues weekly; set contact terms on encounters to meet minimum payment requirements; follow up on delinquent formal payment plans. Prepare encounters for audits, document and charge with audit results; research self-pay encounters for insurance coverage and forward information to the proper area for encounter updates. Prepare encounters for recommendation of refunds; verify employment and check probate court for property and estate claims. Review discharged patients for correctness of patient and insurance information and necessary forms; recommend encounters for suit or placement with an outside collection agency or attorney. Review Mobile County Record for court action involving patient encounters; submit encounters for estate filing. Maintain a thorough and current knowledge of billing requirements and reimbursement methodologies for all assigned coverages; maintain reports and lists as required by management. Collect and reconcile encounters for assigned coverage; respond timely and accurately to written billing inquiries from patients and/or insurance companies. Make necessary demographic and insurance additions, deletions, and changes to the system guarantor/patient information; utilize online systems for follow-up and reconciliation of encounters. Work audit reports received from insurance companies; maintain encounter integrity by ensuring that insurance pro-ration, adjustments and transactions are accurate. Reconcile encounters from insurance Explanation of Benefits; monitor insurance payments and allowances for proper reimbursement per contract; reconcile credit balances. Check work items and email daily and take appropriate action; identify solutions to work-related problems and issues. Request medical records as needed and follow up on receipt; communicate with physicians, patients, families and USA personnel in person and via telephone. Communicate work-related problems and issues to supervisor or management staff; maintain accurate and complete records by documenting all follow-up activities with insurance company or patient clearly and concisely on the patient encounter. Maintain proper filing of patient and insurance correspondence including Explanation of Benefits and insurance denials; maintain contact file folders on all patients with established contract terms. Adhere to hospital policies including confidentiality; maintain regular and prompt attendance; work schedule as defined and overtime as required; perform related duties as required. Qualifications
High school diploma or equivalent and one year of medical billing and/or collections experience in a medical office setting. Hospital billing and claim follow-up experience relating to commercial, UHC and Medicare Advantage plans is highly preferred.
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