Insurance Biller- 813050

• Submits all clean claims to the appropriate insurance payer the same day as the claim is loaded into the Editor with the exception of weekends.
• Reviews payer EOB’s but not limited to payment accuracy, patient liability, and appeal grievances if applicable.
• Files appeals on denied claims and/or forwards to the Nurse Auditor for review if applicable
• Maintain better than an 80% clean claim average.
• Attach but not limited to the medical records, implant invoices, and itemized bill to the claim when applicable
• Process incoming mail correspondence from the payers within 5 business days
• Work assigned billing reports within 2 business days
• Follow up with the insurance companies by phone and or web for the status of outstanding claims if applicable
• Respond to patient inquiries regarding the status of the patient’s insurance within 2 business days
• Submit newborn notifications to income support 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
• Take payments over the phone.
• Print UB and 1500 hardcopy claims when required by the payer
• Bill secondary claims before the timely filing deadline
• Research late charges to determine the cause; inform your supervisor if they are a regular occurrence.

• Handle incoming correspondence and inquiries on accounts.
• Report trends/issues to 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 if applicable
• Forward patient complaints regarding care to your supervisor for entry into the appropriate resolution pathway

Education

Required:

    High School

Licenses & Certifications

Preferred:

    C-Heartsaver