Preparing and submitting billing data and medical claims to insurance companies.
Verify all demographic and insurance information in patient registration of the practice management system at the time of charge entry to ensure accuracy.
Responsible for insurance verification processes of verifying patient eligibility, coordinating medical benefits, gaining approval for planned procedures and services, and determining patient coverage/responsibility for services to be provided.
Ensuring the patient’s medical information is accurate and up to date.
Preparing bills and invoices, and documenting amounts due for medical procedures and services.
Collecting and reviewing referrals and pre-authorizations.
Clearing house rejections need to be rectified in timely manner.
Contacting various payers as needed to verify or obtain information.
Ensuring client satisfaction by an effective and regular follow-up on all outstanding claims to maximize the collection of practice.
Monitoring and recording late payments.
Maintain the protocols and documentation of each performed task.
Following up on missed payments and resolving financial discrepancies.
Follow-Up on unpaid claims within the Standard Billing Cycle timeframe.
Communicating with Providers, Insurance Companies and assisting Patients.
Handling Account Receivables, Denial Management, and Appeal Management.
Maintaining accurate records of payments received and outstanding balances.
Working with the Billing Manager to ensure that all payments are processed.
Examining patient bills for accuracy and requesting any missing information.
Investigating and appealing denied claims.
Swift and accurate remedial actions on claims denied by healthcare insurances.
Verify any secondary and tertiary medical insurance benefits.
Understanding of relevant Key Performance Indicators (KPIs) and working towards positive results for the assigned clients against all KPIs.
Monitor and track patient authorizations, obtain updated authorizations for ongoing treatment, and communicate changes to appropriate team members.
Verify private, government and third-party insurance information, including eligibility, out-of-pocket costs, prescription coverage and patient portions.
Maintaining patient confidentiality and information security.
Perform additional duties as requested by Supervisory or Management team.
Ensure the quality of service, timeliness and accuracy in the entire billing cycle.
Carry out routine communication with your Superiors and provide them daily updates.