Responsible for the day to day tasks of revenue cycle management. This includes verification of patient information, assigning procedure and diagnosis codes, entering charges, submitting claims to insurance carriers, creating statements and posting payments and adjustments.  

Major Duties:

• Assigns procedural and diagnostic codes for services and enters charges into practice management software.  Completes follow-up and collections on outstanding claims.


• Submits claims to insurance carriers electronically or via mail.  Assures all claims are filed within timely filing requirements of each payer.  


• Prepares monthly statements on a regular basis and itemized statements as requested.


• Reviews incoming mail for payments.  Posts payments and adjustments to accounts in the practice management software.


• Develops payments plans for self-pay patients.


• Prepares daily bank deposit. 


• Reviews collection actions on accounts and provides recommendations for further collection proceedings based on age of balance and dollar amount.


• Ensures safe keeping of petty cash and performs reconciliation daily.


• Receives, processes, and documents payments of cash, check and credit cards.       


• Monitors and supports efforts of Registration Coordinators regarding insurance benefit verification.


• Communicates to patients, guarantors and insurance companies regarding payments, deductibles, co-payments, co-insurance, and other payer responsibilities.  Provides estimates of charges upon request.


• Contacts insurance carriers to determine reason for non-payment.  Sends additional information in a timely manner as requested.   


• Maintains positive relationships with patients/guarantors, insurance companies, and business associates.


• Maintains competencies in current trends, rules & regulations regarding medical billing, coding, & collecting.  Communicates changes to Supervisor / Administrator.   


• Analyzes insurance carrier payments in comparison to payer contracts to ensure proper payment. 


• Maintains accurate timekeeping records for all hours worked, including time away from work.


• Prepares and presents month end reports.


• Employee has ability to access ePHI.  Employee has been educated regarding access and is aware it is limited to information necessary to complete their job duties.  Employee has also been advised of the “test” patients that they may access for training purposes.  Employees should not access any ePHI that does not directly relate to their daily work function. 


• Performs other related duties as assigned or requested. 

Qualifications:

• High school diploma or equivalent required.


• CPC through AAPC strongly preferred.


• One (1) year medical office revenue cycle experience preferred.


• Must be able to pass a drug screen and background check.

Skilled at using computer, telephone system, fax machine, scanner, printer & copier