Responsible for the management of Medicare accounts through patient written and verbal directions, aged trial balance reports, and Medicare rejection reports for the accurate and timely filing of claims for maximum reimbursement. Ability to provide support to other Accounts Receivable departments, as needed. Adhere to all departmental policies and procedures.

Responsibilities


  • Customer service duties include answering telephones for patients and others regarding billing inquiries and resolving billing issues.
  • Act as resource to CPL personnel and clients regarding Medicare compliance guidelines.
  • Accurately enter information provided by various sources to correct claims in regards to CPT and ICD‑10 codes and send out in a timely manner to Medicare.
  • Audit accounts showing Medicare/Medicaid/Private Insurance denials to resolve balances.
  • Ability to interpret Explanation of Medicare/Medicaid/Private Insurance Benefits.
  • Resolve invoices from outside laboratories for Medicare/Medicaid/Private Insurance patients.
  • Ability to stay work focused and perform job duties efficiently and accurately. Must have strong organizational skills.
  • Strong data entry skills, with the ability to meet production guidelines as set by the Accounts Receivable Director.
  • Employee must comply with Clinical Pathology Labs' compliance policies and procedures.
  • Duties include but are not limited to the above mentioned responsibilities.
  • Medicare/Medicaid/Private Insurance Background
  • Claims Exp-reading EOB/CSR
  • Verify ineligibility
  • Follow up with billing/payment exp a plus (example-claim was denied, errors)
  • Typing/10 key test to be given after interview 40 wpm min
  • Microsoft Office
  • Email etiquette
  • Individual metrics to meet- Weekly production of 300 accounts/ passing of audits every month
  • 8-5 hours
  • Databases used at SHUSA -NAVINET-also used by Private Ins Or NOVA TAS experience is a plus


Scope:  Respects and maintains the confidentiality of information relative to the laboratory.  Adheres to all accounts receivable policies, procedures and compliance guidelines.  Works with minimal direction, consults with Team-leader or Supervisor as needed.

Qualifications

Education:  High School Diploma or GED

Experience:  Preferred at least two years in a standard Medicare or related HMO plans in

a multitask environment, including customer service. Strong background in coding

procedures preferred. Bilingual skills, private insurance experience and/or lab billing a

plus.

Skills:  Ability to communicate effectively at all levels within the company and with patients and physician office staff.  Knowledge of microcomputer technology and terminology.  Ability to type at least 40 wpm, demonstrate 10 key proficiency and current departmental standards are required.  Develop effective and harmonious work habits and relationships.  Ability to read and comprehend English.

 

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