The specific duties, as well as the amount of time you would spend on these, will vary from one setting to another. That said, your occupational duties may include:
- Obtaining referrals and pre-authorizations as required for procedures.
- Checking eligibility and benefits verification for treatments and equipment.
- Reviewing patient bills for accuracy and completeness, and obtaining any missing information.
- Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
- Following up on unpaid claims within standard billing cycle time-frame.
- Checking each insurance payment for accuracy and compliance with contract discount.
- Calling insurance companies regarding any discrepancy in payments if necessary
- Identifying and billing secondary or tertiary insurances.
- Reviewing accounts for insurance of patient follow-up.
- Researching and appealing denied claims.
- Answering all patient or insurance telephone inquiries pertaining to assigned accounts.
- Setting up patient payment plans and work collection accounts.
- Updating billing software with rate changes.
- Updating cash spreadsheets, and running collection reports.
In addition to these general duties, the employer may request that you perform other duties that fit with your training and background experience or provide further training for new duties.
- A high school diploma
- Knowledge of business and accounting processes usually obtained from an associate’s degree, with a degree in Business Administration, Accounting, or Health Care Administration preferred.
- A minimum of one to three years of experience in a medical office setting.
- Experience with medical billing and coding.
- Experience with Durable Medical Equipment billing is a plus.