Medicare Biller/ Medicare Collector
Company: Gerald Champion Regional Medical Center
Location: Alamogordo
Posted on: June 25, 2022
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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
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