Job Description
Job Description
SUMMARY :
Coding & Charging Capture Integrity Analyst frequently interact with patients, doctors, and insurance companies, so they need some experience with customer service tasks and the ability to maintain patient records and confidentiality and ensure that patient information is complete and up to date.
RESPONSIBILITIES AND DUTIES :
- Obtain and verify insurance eligibility for services provided and document complete information in system
- Determine patient’s financial responsibilities as stated by insurance
- Configure coordination of benefits information
- Ensure assignment of benefits are obtained and on file for Medicare claims if necessary
Resolve billing queries , which can include :
Bad addresses (call patient)Missing authorizations (request from office)Retrieval of Missing OP and or Consult Notes (retrieving from Citrix)Other miscellaneous query reasonsSort correspondence / EOBs and email to 3rd party billing companyRetrieval of EOBs and faxesRequest correct CPT and ICD-10 codes from providersProcessing of payment batches to 3rd party billing company.Document all pertinent communication with patients, physicians, insurance company as it may relate to collection proceduresIdentify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programsHandle inbound calls from patients, physician offices, and / or insurance companiesResolve claim rejections for eligibility, coverage, and other issuesReviewing patient balance accounts, and making collection calls to patients requesting payment, and insurance companies if necessary.Other duties as assigned.EDUCATION & EXPERIENCE REQUIREMENTS :
Minimum of 6 months of insurance verification experience (healthcare) preferred SKILLS & ABILITIESREQUIREMENTS :
Strong customer service skillsMedical billing experience preferredExperience with payors preferredExperience with prior authorizations preferredPHYSICAL REQUIREMENTS :
Body Positions : Sitting and standing for prolonged periods.Body Movements : Arm and hand dexterity.Body Senses : Must have command of close and distant sight, color perception and hearing.Strength : Ability to lift and move up to 25 pounds.