Allegheny Health Network
Job Description :
Processes pro-fee billing activities.
- Posts co-payments, patient payments, and insurance company payments (paper and electronic), and denials. Performs reconciliation of payments. Prepares and deposits payments received. (25%)
- Uses CPT, ICD-9, and payer specific codes and modifiers to prepare and enter charges for entry (includes office, hospital, and outpatient charges). (20%)
- Assists customers with patient billing inquiries. Identifies unpaid balances (insurance and patient) through A/R reports and takes appropriate actions. (25%)
- Obtains and enters patient demographic, insurance, and referral/precertification information in the billing system. (10%)
- Verifies insurance information via hospital and insurance carrier systems. Ensures that electronic and paper claims are sent to insurance carriers in a timely manner. (10%)
- Maintains current knowledge of federal and state reimbursement policies/regulations and system policies pertaining to billing. Ensures compliance with regulatory requirements. (10%)
- Performs all other duties as assigned, including but not limited to supporting front end office processes.
- High school diploma or GED; or one to three months related experience and/or training; or equivalent combination of education and experience.
- 1-3 years’ healthcare billing experience.
- Graduate of a medical billing program.
- Medical Records training and OASIS education.
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