Essential Duties and Responsibilities:
- Include gathering and verifying order information, determining eligibility, insurance coverage and potential financial responsibilities.
- Oversee the entire order and invoice process from patient registration and insurance verification to confirmation of delivery.
- Analyze and resolve billing and reimbursement issues to ensure timely and accurate payments from insurance carriers and patients.
- Maintain up-to-date knowledge of billing guidelines, payer regulations, and compliance requirements.
- Work closely with clinical staff to ensure services are accurately documented and coded.
- Perform regular audits of billing practices to identify areas for improvement and ensure compliance with federal and state regulations.
- Patient Registration: Collecting and recording patient demographic information, including personal details and insurance information, during the registration process. Ensuring all necessary forms and documents are completed accurately.
- Insurance Verification: Confirming the patient's eligibility, coverage, and any pre-authorization requirements for medical services.
- Billing Support: Working closely with the billing department to ensure accurate and timely submission of claims. Resolve insurance-related billing issues and discrepancies.
- Documentation and Records: Maintaining detailed and accurate records of patient insurance information and interactions. Ensure compliance with healthcare privacy regulations, such as HIPAA (Health Insurance Portability and Accountability Act).
- Problem Resolution: Advocate on behalf of patients to ensure they receive the maximum allowable benefits.
- Adherence to Policies: Adhering to the organization's policies and procedures related to patient registration and insurance processes. Stay updated on changes in insurance regulations and procedures.
Required Qualifications:
- At least 2 years solid experience with US Healthcare handling end-to-end RCM
- Experience with medical insurance and/or insurance verification is highly preferred.
- Computer proficiency in MS Word, Excel, and Outlook preferred
- Database data entry experience preferred.
- Strong knowledge and use of the English language, both written and verbal
- Work history of excellent attendance and punctuality
- High comfort level working with culturally diverse team members and clients.
- Proficient mathematical skills, including addition, subtraction, multiplication, and division.
Preferred Qualifications:
- Startup / rapid growth experience
- Life sciences, pharmaceutical, or medical device experience.
- Knowledge of medical terminology preferred.
Language Skills
Must be able to communicate effectively in English. Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of an organization.
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