Responsible for submitting accurate, clean claims to third parties and private pay accounts, collecting and posting payments to patients' accounts, and following up on unpaid/incorrectly paid claims through to resolution of the claim.
Responsibilities
1. Register all new patients into the computer system, ensuring that all necessary information is added accurately.
2. Analyze physician orders, certificates of medical necessity, or prescriptions submitted by physicians for proper documentation to ensure compliance with insurance billing regulations. Obtain additional information from the physician's office when necessary.
3. Track and obtain renewal of physician orders or CMNs for recurrent orders as necessary.
4. Prepare patient charges for billing.
5. Review claims for accuracy prior to submission for payment.
6. Review all payments for accuracy, post payments to patient accounts, and adjust accounts accordingly.
7. Analyze incorrect payments and denied claims, resubmitting with additional information as needed.
8. Use aging reports to track and follow up on unpaid claims, resubmitting as necessary.
9. Perform typing and clerical duties related to the above responsibilities.
10. Perform all other related duties as assigned.
Job Qualifications and Specifications:
A high school diploma and a minimum of one year of relevant experience or equivalent is required.
About Care New England Health System (CNE): Care New England and its member institutions—including Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group—are trusted organizations fueling medical research, attracting top specialists, and offering innovative health programs.
Americans with Disabilities Act Statement: External and internal applicants, as well as current employees who become disabled, must be able to perform essential job functions with or without reasonable accommodations, as determined by the organization.
EEOC Statement: Care New England is an equal opportunity employer. All applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.
Ethics Statement: Employees are expected to conduct themselves in accordance with the organization's ethical standards, including hospital policies, mission, vision, and values.
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