This position exists to ensure the financial well-being of the PCHS organization through timely and accurate filing of insurance claims, collection of patient accounts, and ensure proper posting of payments into existing PCHS systems for medical, dental and/or behavioral health. This position may be responsible for any or all the essential functions listed below in the electronic health record systems.
ESSENTIAL FUNCTIONS/ROLES & RESPONSIBILITIES OF THE POSITION
- Collaborate with staff, providers, team members, patients and insurance companies to get all claims processed and paid.
- Assign correct diagnosis (ICD-10) and procedure (CPT) codes based on direction from providers.
- Review and appeal unpaid and/or denied claims.
- Prepare, verify and submit prior authorizations.
- Verify patient coverage and insurance benefits.
- Answer patient billing questions
- Process refunds
- Handle collection efforts on all unpaid accounts and submit to Collections on a timely basis.
- Continuous data entry into state/federal/local reporting programs such as AKAIMS
- Administrative responsibilities associated with meeting reporting requirements.
- Audit data when necessary and/or appropriate
- Generate, process and/or mail monthly statements.
- Knowledge of how to post in all electronic health record systems.
- Post payments, adjustments, and denials in systems as appropriate
- Balance daily deposits to daily postings for all systems
- Check allowables to ensure correct payment and account balances.
- Post zero pay correspondence as pertaining to: deductibles, copayments, and denials.
- Process credit card payments and balance credit card machine transactions daily
- Run weekly conveyance reports to verify everything is in balance for month end.
- Ensure that desktop procedures are current.
- Perform month end closing procedures.
- Perform duties as assigned by manager.
Please view our website at www.pchsak.org to learn more about this position and/or PCHS.
Please apply online at www.pchsak.org or contact HR directly at firstname.lastname@example.org / 907-260-5017.