Medicare Biller/ Medicare Collector

Company: Gerald Champion Regional Medical Center
Location: Alamogordo
Posted on: June 25, 2022

Job Description:

* Submits all clean claims to the appropriate insurance payer the same day the claim is loaded into the Editor with the exception of weekends and Holidays
* Reviews payer EOB's but not limited to payment accuracy, patient liability, updating the financial class, notify commercial biller to submit secondary or tertiary insurance, and appeal grievance.
* Files appeals on denied claims and/or forwards to the Nurse Auditor for review/appeal
* Enter denials on the Denial Log
* Enter the USPS tracking number in the Patient Accounts system
* Enter the USPS delivered date in the Patient Accounts system
* Contact payer to ensure an appeal was received
* Maintain better than an 80% clean claim average.
* Attach but not limited to the medical records, implant invoice, and itemized bill to the claim before billing if applicable
* Process incoming mail correspondence from the payers within 3 business days
* Work assigned billing reports within 2 business days
* Work the rejection report daily to resolve problem accounts
* Follow up with the payer via phone and/or the website for the status of outstanding claims
* Respond to patient inquiries within 2 business days
* Respond to interdepartmental inquiries within 2 business days
* Respond to payer requests within 2 business days
* Respond to emails within 2 business days
* Submit newborn notifications if applicable
* Review/resolve the accounts on the Unbilled Report daily (accounts that are on hold and haven't been processed by the editor).
* Enter detailed notes explaining account activity in the Patient Accounts system
* Process payments over the phone if applicable
* Print UB and 1500 hardcopy claims when required by the payer
* Submit primary, secondary and tertiary claims before the timely filing deadline
* Research late charges to determine the cause; inform supervisor of regular occurrences and trends
* Report A/R account trending issues to the Supervisor and the Director of Patient Financial Services
* Follow up with all insurance companies within 30 days of billing if there is no payment on the account
* Work the eScan reports timely if applicable
* Forward patient complaints regarding care to the supervisor for entry into the appropriate resolution pathway
* Notify supervisor of payers that accept electronic billing currently billed hard copy

Keywords: Gerald Champion Regional Medical Center, Las Cruces , Medicare Biller/ Medicare Collector, Other , Alamogordo, New Mexico