Insurance Biller

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Job Summary In a hospital and/or professional office environment, the Systems Account Resolution Analyst is responsible for billing and patient account reconciliation. This job requires critical thinking skills, organizational skills, account investigation, claim escalation, and overall account resolution of a patients and/or insurance balances. This is accomplished by utilizing insurance web portals, call inquiries, written correspondence, and collaborating with internal departments.

This role requires an employee to work in a team environment as well as independently. The System Account Resolution Analyst will contribute to meeting departmental goals as well and organizational goals.

Essential Job Functions and Responsibilities:

Contacts insurance carriers to facilitate payments, review underpayments and denials. Refer difficult accounts to denials team for further action

Identifies barriers to efficient departmental operations related to self-pay billing/trends in insurance denial and takes an active role in developing appropriate solutions actively works daily work queue and clearing house denials

Assists the self-pay follow up team in areas such processing financial assistance applications, payment plans through third party vendor, preparing patient refund requests, processing bankruptcy notifications, return mail, etc Reviews payer bulletins to stay current on updates.

Communicates with departments and Coding Vendor to resolve claim issues.

Respond and takes action related to calls, emails, and faxes related to patient billing in a timely and professional manner

Uses a patient-centric approach to answer questions and provide information in a professional manner

Understand all payer regulations to effectively communicate with patients about charges, payments and adjustments on their account

Investigate patient inquiries/disputes surrounding charging, coding, payments, locations, services, insurance coverage, etc Works with individuals when appropriate at various levels of the organization to find resolution on patient disputes

Updates account information (addresses, insurance, etc.) and rebills as appropriate to initiate the next steps in the billing and collection cycle

Qualifications:

High School Diploma and at least three (3) years of revenue cycle experience which may include insurance and self-pay billing and collections, remittance processing, patient access and/or are other revenue cycle areas in a hospital or physician office setting. Bachelor's Degree Preferred Communicate effectively and work directly with third parties (insurance payers, patients, internal departments, vendors, leadership, etc.) to relay updates on patient accounts timely

Ability to read and write in English is required

Organize and articulate account disputes, and written letters of appeal

Excellent customer service and communication as well as interpersonal, organizational and analytical skills

Proficient in Office Applications (e.g. Excel, Word, Google Sheets, Google Mail)
Comprehensive knowledge of Professional and/or Hospital revenue cycle

Ability to work in a high volume setting and respond to insurance or patient inquiries in a timely manner

Ability to identify and communicate payer trends and/or system trends

Ability to navigate payer websites

Knowledge of payer contracts, regulations and guidelines, as well as State and Federal laws relating to billing, collection, and financial assistance procedures preferred

Familiar with medical and insurance terminology

Proficient in the use of a computer and relevant hospital software applications e.g., Meditech and/or eClinical Works Understanding  and adherence to HIPAA Regulations and Release of Information Rules Models teamwork through cooperation and collaboration within and outside the work group

Ability to…