General DescriptionDepartment: Billing Office
Work Schedule/Hours: Monday-Friday 8:30a.m.-5:00p.m. 40 hrs.
Responsible for collection of unpaid third-party claims and appeals. Works with the payers' to resolve issues and facilitate prompt payment of claims.
Duties and Responsibilities:
* Utilizes the EPIC system for the daily flow of accounts to identify unpaid claims for follow-up.
* Communicates with third-party payers, patients, physicians, and other parties to resolve unpaid claims. Review and update patient registration information (demographic and insurance) in EPIC as needed.
* Posts appropriate adjustments and discounts as dictated by departmental policies.
* Utilizes all methodologies of third party payor contact [web, Real-Med, fax, etc.] for the timely resolution of unpaid claims.
* Retrieves supporting documents (medical reports, authorizations, etc) as needed for review and/or submission to third-party payers. Non CPCs must have all medical records reviewed and approved by Lead Staff CPCs prior to mailing out.
* Identifies and informs the supervisor / Production Unit Manager of issues, trends and/or problems associated with non-payment of claims.
* Works with Claims Coordinator to resolve edits associated with unpaid, unprocessed and/or rejected claims.