Responsible for preparation, submission and management of claims to all insurance carriers. Maintain knowledge of current billing requirements for all insurance carriers.
Track and monitor financial activities of all patients with co-pays, deductibles, financials, spend downs or liabilities. Re-verify Medicaid monthly and commercial insurances each January. Obtains information regarding insurance benefits to determine patient responsibility.
Track all financial assessments approved by CFO and notify social worker and patient when new financial assessments need completed.
Reporting of all admissions, certifications and discharges to Medicare-81A’s and other insurance carriers as required.
Resolve billing issues of outstanding claims providing information needed such as medical records or denials from other insurance plans and maintain current aging of accounts receivables.
Verify all Non-Medicare Service Coverage Forms to determine if self-pay benefits may be billed to patients. Monitor and mail patient statements as determined per hospice policies.
Prepares, updates and maintains nursing home pro-active billing, communicates with nursing homes as necessary, obtain signed spreadsheets and submit timely to Accounts Payable Department. Maintain Quarterly R&B rates.
Responsible for all cash posting and reconciliation. Track all financial Assessments.
Maintain confidentiality of patient information.
Maximize use of computer and other resources to effectively improve time management.
Work cooperatively with internal and external customers to resolve all billing issues.
Serve as an intermediary between patients and their healthcare provider as needed.
Special project and other duties may be assigned
Follows all applicable federal and state regulations, including HIPAA, compliance and employment regulations. Complies with all HOD policies and procedures.
Other duties as assigned.