Biller - Steward Health Care

This position is responsible for the complete and accurate capture of patient insurance data and referral/authorization management. Includes tracking and creation of referrals for all visits. Contacts patients by telephone to collect missing pertinent data. Communicates with referring physicians and/or practices to obtain prior approvals for services. Reviews and responds to denied claims and works toward denial recovery. In addition, he/she will perform other related duties as required.

KEY RESPONSIBILITIES:

(Use bullets for specific responsibilities)

• Provides superior customer service to internal and external clients, customers, and patients as referenced in the “Service Excellence Standards."
• Practices and promotes a "patient-centered care model" within administrative standards.
• Provides primary fiscal management of all patient insurance and insurance referral data. The principle focus is to ensure that all pending services have appropriate insurance coverage and is reimbursable.
• It is expected that all telephone communication will be answered or initiated in a cheerful and welcoming manner as per the policy of SMG.
• Review and respond to all insurance rejection and/or claim denial reports and professional billing agencies. Initial review will be made in collaboration with the Practice Manager. However, the Billing is responsible for follow through of the recommendations made and achieving denial recovery of those charges. All responsive documentation is to be retained and filed for continual monitoring and follow up.
• Perform all other related or similar duties as required or as requested by the Practice Manager or Director of Practice Management.
• Participates in role expansion, personal and center development.
• Assist with administrative cross-coverage and other assigned duties.

REQUIRED KNOWLEDGE & SKILLS:

(Examples: Ability to work independently and take initiative; Good judgment and problem solving skills; Communication skills; Interpersonal and organizational skills; Level of confidentiality)

• Organizational and problem solving skills.
• Monitor staff efficiency and adherence to policy and procedure.
• Must be able to multi-task and prioritize daily tasks.
• Excellent written and communication skills.
• Proficiency with computers.
• Ability to work independently and take initiative.

EDUCATION/EXPERIENCE/LICENSURE/TECHNICAL/OTHER:

I. Education: Associates Degree

II. Experience: 2-3 years of experience in Referral/Billing Management required

III. Certification/Licensure:

IV. Software/Hardware:

V. Other: Computer literacy, Familiarity with Referral/Insurance Eligibility Programs, Microsoft Office including Word, Excel, Access