Billing Representative- Primary Care-Full Time Days

GENERAL SUMMARY

• Department: Primary Care
• Schedule: 8-hour day shift, Monday-Friday
• Location: South Lyon, MI

Determines and verifies insurance coverage and coordination of benefits from all sources for assigned area. Ensures proper adequate and timely billing to ensure prompt payment.

* Confirms insurance coverage. Determines necessity for pre-authorization and obtains authorization for scheduled procedures.

* Determines financial responsibility for services to be provided. Notifies patients and/or practitioners of any services requested and/or referred that are not authorized by insurance.

* Communicates with patients and practitioners regarding financial responsibility and insurance coverage issues.

* Maintains detailed documentation in the patient account record of all billing activities. Maintains documentation of claims processed as part of the daily claims reconciliation process.

* Prepares and completes claims for commercial insurance companies, third party organizations and/or government or self payers.

* Researches, analyzes and reconciles Medicare/Medicaid billing and reimbursement practices.

* Maintains detailed documentation in the patient account record of all billing activities.

* Maintains documentation of claims processed as part of the daily claims reconciliation process.

* Consults with appropriate parties to resolve unbilled claims. Reviews recent accounts for proper billing practices and reimbursement.