Billing Representative- Internal Medicine- Full Time

GENERAL SUMMARY

Determines and verifies insurance coverage and coordination of benefits from all sources for assigned area. Ensures proper adequate and timely billing to ensure prompt payment.

Responsibilities:

• Confirms insurance coverage. Determines necessity for pre-authorization and obtains authorization for scheduled procedures.
• Determines financial responsibility for services to be provided. Notifies patients and/or practitioners of any services requested and/or referred that are not authorized by insurance.
• Communicates with patients and practitioners regarding financial responsibility and insurance coverage issues.
• Maintains detailed documentation in the patient account record of all billing activities. Maintains documentation of claims processed as part of the daily claims reconciliation process.
• Prepares and completes claims for commercial insurance companies, third party organizations and/or government or self payers.
• Researches, analyzes and reconciles Medicare/Medicaid billing and reimbursement practices.
• Maintains detailed documentation in the patient account record of all billing activities. Maintains documentation of claims processed as part of the daily claims reconciliation process.
• Consults with appropriate parties to resolve unbilled claims. Reviews recent accounts for proper billing practices and reimbursement.