About this role
• Prepare and submit claims, electronically or by paper, for Clinic, Surgical, Physical Therapy & Orthopedic departments to various insurance companies.
• Post Payments for Clinic, Surgical, Physical Therapy & Orthopedic departments.
• Follow up with Doctors and other clinical staff for any missing information as it pertains to billing.
• Verify benefits or obtain authorization, referrals, etc. as needed.
• Medical coding: Creates accurate medical coding.
• Billing forms: Submits billing forms to the Workers' Compensation
• Review and follow-up: Reviews the processing and payments, and follows up on claims that are denied.
• Appeal any and all denials for Clinic, Surgical, Physical Therapy & Orthopedic departments.
• Communicate benefits to the Medical Assistants, Front Desk & Physical Therapy Department by set deadlines.
• Explain benefits or answer any other insurance related questions from patients.
• Analyze, prepare and mail patient statements, implement and follow up on patient payment plans and collect patient balances.
• Resolve any patient complaints in a professional and courteous manner.
• Prepare accounts for collection agency that have been deemed non-collectible.
• Meticulous Accounts Receivable collection and follow-up with insurance and patients weekly
• Presenting weekly reports showing progress.
• Review Charts and Submit WMC Department Authorization Requests.
• Follow up with WMC Coordinator, and or Front Desk to obtain proper insurance and/or billing information.
• Answer e-mail and/or voicemails in a timely and professional manner.
• Special projects as needed when determined by supervisors or management.
• Be responsible for maintaining accurate records and providing detailed, professional notes in patient files.
• Review Explanation of Benefits to determine next appropriate steps to seek authorization for patient treatment