Tier 1 Business Services Specialist II - Billing/ Coding in Cookeville, Tennessee at CAMPBELL CLINIC PC

Position Summary

Responsible for all aspects of assigned patient accounts after charge entry to final resolution

Essential Functions Statement(s)

• Verifies and updates insurance information and demographics
• rebills charges when insurance corrections are made
• Keeps up with changes in billing and pre-cert guidelines (including LCD's)
• Reviews insurance eligibility
• Determines and reviews financial responsibilities and insurance coverage with patients
• Resolves patient balance related questions
• Reviews surgery costs and establishes payment plans for patient portion
• Reports denial trends to coders and managers
• Completes charge entry
• Processes patient and payor refunds
• Reviews insurance eligibility and rejections/errors
• Follows-up on aging buckets
• Identifies accounts for referral to outside collection agency
• Edits claim holds
• Keeps up with changes in payor processes and reports them to coordinator for appropriate action
• Obtains all precertification
• Responds to correspondence from payors and patients
• Regular and predictable attendance
• Ability to work in a cooperative manner with others
• Performs other duties as assigned

Education: High School Graduate or General Education Degree (GED)

Experience: Previous healthcare billing experience is required. Coding experience preferred

Computer Skills: Must be computer literate. Basic computer skills required. Must be able to type.

Campbell Clinic Benefit Summary: