Position Summary: Research and secure payment for managed care accounts within the billing department. Utilize billing, collecting, research, correspondence, and independent problem solving skills of account errors within Omni Family Health standards and timeframes. Reconcile complex, multi-payment accounts as necessary.
- Perform the adjustments, refunds etc. common with billing knowledge to bring account to zero balance within established timeframes.
- Follow up on required daily accounts based on assigned practice and/or payer to reduce the A/R and maintain Omni Family Health Key performance indicators (KPI).
- Submit appeal letters on unpaid and underpaid claims applications.
- Prioritize work to minimize interruptions and increase efficiency in collections process.
- Prepare and submit weekly & monthly AR summary of activity report for all assigned practices/payers to department manager with detailed action plans and/or unresolved issues.
- Establish and maintain an efficient filing system for all Omni Family Health employed provider group and payor contracts.
- Perform retrospective audits of new self-pay accounts to update demographic information.
- Participate in accounts receivable collection campaigns as needed to meet department goals.
- Notify the contracted billing company of payor written refund requests. Services accounts where Omni Family Health has a request for patient refund. Prepares paperwork for the refund approvals.
- HIPAA compliance – Responsible for enforcing compliance with all HIPAA regulations and requirements. Treats all member information confidential.
- Compliance – Ensure compliance with all local, state, and federal regulations.
- QA/QI – Participate in QA/QI activities and contribute towards the overall performance improvement of the organization.
- IT – Required to learn and use the Electronic Health Record and Practice Electronic System and its components as required by the job functions and highlighted in the Policies and Procedures.
- All employees will participate in Patient Centered Home Health Model at Omni Family Health.
Qualifications, Education, and Experience
- High school diploma or GED
- Minimum of one year billing and accounts receivable experience in a physician practice environment
- Proficiency and accuracy with multiple office tools and software.
- Accurate data entry skills with the ability to input data into computer systems, compile statistics, and generate reports.
- Ability to work under pressure.
- Ability to demonstrate effective communication skills with providers and management staff.
- Ability to draft and implement collection letters.
- Proficient with excel and other Microsoft office products.
- Knowledge payor contracts.
Responsible to: Collections Supervisor
Classification: Full-time or Part-time, Non-exempt