Job Description

Billing Follow Up Rep-TMCOne
Job CategoryClerical
ScheduleFull time
Shift1 - Day Shift

SUMMARY:

Performs Medicare billing, or State Fair Hearing analysis and preparation, or refunds for patients which includes a complex review and reconciliation of government payers, Medicare patient accounts, or credit balances on patient accounts.  Resolves problems and demonstrates complete understanding of payer contracts and/or payer requirements to ensure timely and accurate payments or timely responses on credits, recoupments, and refund requests. Responsible for balancing all cash receipts and daily and monthly workbook with the finance department.    Makes independent decisions based on reconciliation, billing, and/or credit balance accounts.     

 

ESSENTIAL FUNCTIONS:

 

Adheres to and supports team members in exhibiting TMCH values of integrity, community, compassion, and dedication. 

Assists management in maintaining or reducing account receivable (AR) days to meet industry standards and improve organizational cash flows.

Ensures patient accounts are refunded and/or billed in a timely, complete, and accurate manner in accordance with payer contracts and payer guidelines, and/or billing and follow-up guidelines (depends on review and reconciliation process).

Prepares and enters contractual write-offs and dispute letters to Medicare or insurance carriers as required.

Serves as information resource to patients and hospital staff regarding credit and collection policies or Medicare polices and benefits.

Provides routine daily internal and external interface with unit/department management and staff, other service areas, information systems, physicians, physicians’ office staff, patients, software/hardware vendors, and third party payers  in order to resolve patient disputes, and/or patient credits, and/or audits, and/or patient concerns,  and/or billing audits.

Assists with problem solving, inquiries, and customer interaction to ensure positive results.

Trains and assists in the implementation of new software programs/systems and related technologies.

Adheres to TMCH organizational and department-specific safety and confidentiality policies and standards.

Performs related duties as assigned.

 

MINIMUM QUALIFICATIONS

EDUCATION:  High School diploma or General Education Degree (GED); or an equivalent combination of relevant education and experience.

EXPERIENCE: Varies based on position, see above.

LICENSURE OR CERTIFICATION: None required.

 

Application Instructions

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