JOB SUMMARY

Responsible for daily customer inquiries from internal and external customers to completion. Responsible for the daily completion of both claims edit, denial, and no response billing functions for timely follow up. Handles internal and external questions to completion. Understands both paper and electronic claims as well as client invoice billing. Responsible for follow up on Accounts Receivable to all payers. Serves as a resource for other Office staff and patients concerning expected payments, payments made and contract conflicts. Performs other duties as assigned.

• Handles telephone communication with patients, insurance companies and other BMG/BMHCC personnel.
• Bills, collects and submits all insurance and TPA claims according to payer guidelines, and established procedures and workflows.
• Works all insurance denials, via paper and/or electronic in work queues with patient on phone.
• Reviews accounts for possible assignment to BD.
• Reviews and sets up payment plans as requested by patient.
• Reviews and processes adjustments as needed to resolve credit balances and ensure account balances are correct.
• Communicates with Insurance companies.
• Reviews accounts for accuracy.
• Reviews items directed to Customer Service through MyChart communications.
• Reviews self-pay accounts forwarded to Customer Service by collection vendors.
• Completes assigned goals