Insurance Billing & Reconciliation Specialist

** 5. Evaluate insurance reimbursement schemes as needed to verify that payments and adjustments have been accurately recorded.
** a. Review credit balance accounts in assigned worklist, review payment history for accuracy. Make a determination if a refund is needed and forward to the appropriate refund agent for resolution.
b. Initiate Insurance retractions as needed for payments posted to the Hospitals Unlocated Cash Accounts. Incorrect payments that require a check will be forwarded to the appropriate refund agent for resolution.

** 6. Communicate with patients as needed for additional insurance or other information needed in order to process a claim.
** a. Generate phone calls or letters as needed to obtain necessary insurance or other related information, prior to an account being placed in self pay.
b. Obtain proper verification of predefined patient demographic information and maintain documentation in order to verify identity.

** 7. Technology – Embraces technological solutions to work processes and practices.
** a. Uses the API payroll system to enter time worked, sick days, vacations and holidays.
b. Uses Meditech to access and run reports.
c. Uses Lotus Notes as a communication tool.
d. Access provider web sites for verification of accounts.

** 8. Safety Awareness – Fosters a “Culture of Safety” through personal ownership and commitment to a safe environment.
** a. Successfully answers safety questions in the annual mandatory education packet.
b. Maintains a neat, organized work environment.
c. Adheres to respiratory etiquette guidelines.
** Age Related Competencies*
* ** Organizational Competencies
** Following are the organizational competencies and corresponding performance standards for all employees in the organization. Indicate how the employee performed relative to these standards by checking the appropriate boxes.

** Service*
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