Performs all functions related to the timely follow-up and collection of third party patient accounts, in accordance with State and Federal rules and regulations and hospital policy and procedure.Â
Reviews reports from insurance companies/government payers for possibility of resubmission.Resubmits, bills patient, or writes-off as appropriate.Files appeals on rejected services within filing deadline. (E)
Follows-up on unpaid third party accounts by telephone and/or tracer within time frames and guidelines set forth in hospital policies and procedures.Prepares rebilling as necessary. (E)
Reviews correspondence received from third party carriers, etc., and responds before insurance company deadlines.Makes request for medical records when necessary. (E)
Reviews payments on accounts for accuracy.Contacts insurance carriers if payment is less than quoted benefits to resolve balance responsibility.Calculates or recalculates contractual allowances and corrects as necessary.Corrects Managed Care discounts, employee discounts, etc., as necessary after recalculating discount. (E)
Documents all insurance activity in computer system. (E)
Demonstrates competence to perform assigned responsibilities in a manner that meets the population-specific and developmental needs of members served by the department. (E)
Appropriately adapts assigned assessment, treatment, and/or service methods to accommodate the unique physical, psychosocial, cultural, age specific and other developmental needs of each member served. (E)
Demonstrates adherence to the CORE values of Santa Rosa Health Care. (E)
Performs other duties as assigned. (M)
High school diploma required.
One (1) year minimum experience with third party billing rules and regulations, preferably in a health care setting.
Must be able to understand both written and verbal instructions.
Performs other duties as assigned.
Must be able to operate a calculator.
Must be able to operate both a calculator and a personal computer for inquiry and input purposes.
Must be able to type a minimum of 35 wpm.
Must have knowledge of mathematical computations required to calculate discounts, contractual allowances, etc.
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.