third party biller

Job Description Summary Accumulate data from Patient Access and Health Information Management for the purpose of submitting compliant third party insurance and physician claims. Initiate all collection calls for payment on aged accounts receivable up to the point of self-pay collections. Generates reports for responsible insurance plans and maintains online collection worklists and online claims editing software for maximum efficiency. Ability to decipher reimbursement schemes for assigned insurance’s to complete the revenue cycle Job Description Salary Adjustment!!! This role just had a market adjustment and offers a higher pay range! Join the great South Shore Health team as a Third Party Biller, where your work directly supports patent care behind the scenes! 1. Maintains up to date knowledge of all Federal, State and Insurance specific billing regulations, policies, procedures and code sets. Retains knowledge of Hospitals Credit Collection Policy. a. Notifies manager of any changes that would effect claim submission 2. Evaluates daily claim file using online claim editing software for submission of UB92 and 1500 claim forms. a. Initiate claim corrections as defined by insurance regulation and hospital policy.’ b. Evaluate unresolved accounts weekly, contact outside departments as needed and submit status to manager weekly to resolve unbillable accounts. 3. Initiate collection of aged accounts receivable through an automated collector work lists. a. Unresolved accounts require insurance company contact by phone, e-mail or designated web site to resolve outstanding balances. b. Collaborate with denial management staff for accounts than require clinical intervention for an appeal process. c. Generate technical appeals as needed for account resolution. d. Provide to manager a detail account history fo