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Advanced Pain Management Center opened its doors in 2000 and has served as a pain management resource for the community and healthcare providers since that time. We currently have an opening for a full-time person experienced in charge/payment posting, patient collection, insurance verification and A/R follow up. This person would want to work in a team oriented environment but would do well working independently within that paradigm.
Primary Job Responsibilities:
Prepares and submits outpatient and surgery center-based physician claims to third party insurance carriers either electronically or by hard copy billing.
Secures needed medical documentation required or requested by third party insurances.
Follows-up with third party insurance carriers on unpaid claims until claims are paid or only self pay balance remains.
Processes denials by determining if claim should be set to patient responsibility and generating a letter of denial to patient or correcting any billing error and resubmitting claims to third party insurance carriers. Must get Administrator’s approval before setting to patient responsibility.
Works with physician or medical record staff to ensure that correct diagnosis/procedures are reported to third party insurance carriers.
Keeps updated on all billing and benefit changes for third party insurance carriers.
Verifies insurance benefits and eligibility.
Maintains confidentiality of all information.
Completes work within authorized time to assure compliance with departmental standards.
Keeps updated on all third party billing requirements and changes for insurance types within their area of responsibility.
Demonstrates knowledge of, and supports, Center mission, vision, value statements, standards, policies and procedures, operating instructions, confidentiality standards, and the code of ethical behavior.
Other
Maintains third party billing logs and research binders.
Performs other duties as required.
Experience with pain management coding and procedures preferred.