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Responsibilities
Perform accurate and timely follow-up, reconciliation, and resolution of outstanding account balances. Analyze and resolve outstanding receivables utilizing remittance reports, payment advisories, explanation of benefits, etc. Verify accuracy of third-party payments. Post contractual allowances where necessary. Refer accounts for billing where appropriate, reassign eligible balances to self-pay and/or third-party billing status. Process third-party payor denials and related correspondence in a timely and accurate manner. Perform administrative and clerical functions including typing, photocopying, filing, calculating, faxing, etc. Collaborate with all departments to resolve edit errors. Maintain knowledge of insurance groups including CPT, HCPC, occurrence, condition, span, and value codes, and modifiers. Maintain supporting documentation for all account changes with department sign-off. Verify insurance information through online access and carrier websites. Review billing, payment, and denial information using automated databases. Identify reasons for payment denials and initiate remedial actions. Utilize denial management systems for reports and workflow. Follow up on unpaid accounts using trial balances, insurance websites, and reports. Correct, adjust, or cancel claims online as needed. Calculate patient liabilities and perform system adjustments for accurate billing. Respond professionally to patient and insurer inquiries, following HIPAA and organizational guidelines. Monitor credit balances and perform necessary claims adjustments or refunds. Create and maintain logs and reports for patient accounts. Support department functions by covering absences and assisting with training. Follow departmental policies and maintain a safe work environment. Participate in educational activities to enhance job performance and compliance. Analyze automated output for accuracy. Provide excellent service to patients, families, visitors, volunteers, and co-workers. Perform other duties as assigned. Minimum Qualifications
- High School diploma or GED.
- 12 months experience in accounts receivable, medical billing, or revenue cycle, or successful passing of the Patient Financial Services Qualifying Test.
- Successful completion of basic Medical Terminology course or exam.
- Proficiency in Microsoft Excel, Word, and Outlook.
- Experience in healthcare preferred; knowledge of EPIC or similar systems advantageous.
Position Details
Purpose: Perform accurate and timely account resolution.
Schedule: Per diem, rotating days, Mon-Fri, 8a-4p or 7a-3p, no weekends or holidays, hybrid during training.
Location: Cape Cod Hospital, Hyannis, MA.
Department: Patient Financial Services.
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