Classified Title: CO Billing & Collection Specialist Working Title: Role/Level/Range: ATO 40/E/02/OC Starting Salary Range: $13.23-$18.23 (commensurate with experience) Employee group: Full-Time Schedule: Working 40 hours per week; Monday-Friday 8:30-5pm Exempt Status: Non-Exempt Location: 16-MD:JH at White Marsh Department name: 10003403-SOM Neuro Production Unit Billing Personnel area: School of Medicine
Will be responsible for the collection of unpaid third-party claims and appeals, using various applications of JHM and JHU/ PBS billing applications.
Specific Duties & Responsibilities:
Work with payers to resolve issues and facilitate prompt payment of claims. Follow-up with insurance companies to collect outstanding accounts for which payment has not been received in response to the claims submission process, either electronically or by paper.
The Specialist will be assigned pay or groups of outstanding patient accounts. Various methods of follow-up will be used including all JHU/ PBS Billing Applications. Use NR follow-up systems and reports to identify unpaid claims for collection/appeal. Gather and verify all information required to produce a clean claim including special billing procedures that may be defined by a payer or contract. Review and update patient registration information (demographic and insurance) as needed. Apply appropriate discounts I courtesies based on department policy. Prepare delinquent accounts for transfer to self-pay collection unit according to the follow-up matrix. Print and mail claim forms and statements according to the follow-up matrix. Retrieve supporting documents (medical reports, authorizations, etc) as needed and submits to third-party payers. Appeal reflected claims and claims with low reimbursement. Confirm credit balances and gathers necessary documentation for processing refund. Identify insurance issues of primary vs. secondary insurance, coordination of benefits eligibility and any other issue causing non-payment of claims. Contact the payers or patient as appropriate for corrective action to resolve the issue and receive payment of claims. Monitor invoice activity until problem is resolved. Process daily mail, edit reports, file or pull EOB batches. Identify and inform the supervisor I Production Unit Manager of issues or problems associated with non-payment of claims.
Minimum Qualifications (Mandatory):
High School Diploma or GED required. One year experience in a medical billing or similar environment required. Knowledge of medical terminology, CPT codes and diagnosis coding required. Additional education beyond minimum experience qualifications may substitute for required experience to the extent permitted by the JHU equivalency formula.
The successful candidate(s) for this position will be subject to a pre-employment background check.
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