Location: Naples, Florida
Posted: December 16, 2016
Reference ID: 225685346
Adecco is currently assisting a local client in their search for a Medical Biller in Naples, FL. If you meet the requirements below please apply at www.adeccousa.com for consideration.
¿ Review pre-bill edits to ensure recovery of charges; ensure compliance with Medicaid, Medicaid MCO¿s and Commercial and other insurance carrier guidelines related to documentation, coding and medical necessity.
¿ Reviews denial holds to assure errors are resolved and claims are re-submitted accurately for payment.
¿ Communicates with insurance carriers regarding clinical information requested and to resolve issues relating to coverage and payment for specific patients and benefits.
¿ Uses Explanation of Payments (EOPs) to determine accuracy of payments and submits adjustments requests to supervisor for approval
¿ Maintains progress notes of outstanding accounts to include detailed notes and steps taken to resolve issues.
¿ Appeals to the third party carrier requesting action with justification and supporting documentation upholding review request and additional payment. Any subsequent follow-up tasks required to get the accounts resolved.
¿ Perform eligibility verification of Athena exceptions for medical practices, three days in advance, without exception. Works self-pay post claim generation insurance findings and updates registrations to reflect new insurance and initiates claim generation.
¿ Consult and advise the Billing Manager with billing problems and initiate plans for solving such problems.
¿ Assist with reimbursement analysis and development of new billing policies and procedures.
¿ Assist in daily and monthly closing reports.
¿ Perform other related duties incidental to the work described herein.
¿ Participates in all in-services and staff education competencies as needed.
¿ Exercises and maintains patient confidentiality by complying with all federal, state and local statues or other agency regulations pertaining to confidentiality and a patient's right to privacy.
¿ Uses strict self-discretion and control in the disclosing of patient information to anyone at any time during or after leaving the HCN facility, except in accordance with all federal, state and local statutes or other agency regulations and HCN policies and procedures relative to release of information and specifically, only to others who are directly involved with the patient's care or have a legitimate "need to know" to conduct his/her assigned HCN duties.
Equal Opportunity Employer Minorities/Women/Veterans/Disabled