DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
  • Supervisory and administrative work managing the insurance and other reimbursement functions of the organization.
  • Follow-up to any problems that arise with third-party payers and collections.
  • Exercises general supervision over employees in the Billing Department and manage the department within the established budget
  • Work is performed in an office environment and requires both desk and counter work. Frequent contact with patients and third party payers. Contact may involve dealing with angry people.
  • Manages the filing and resolution of claims with individual carriers or agencies. Insures maximum reimbursement through settlement negotiations.
  • Monitors change in the medical insurance industry and adjusts operating procedures accordingly. Aggressively pursues cost reimbursement through settlement negotiations.
  • Reviews and evaluates health insurance claim policies and procedures for insurance plans. Develops new procedures with the Administrator and the appropriate committee to improve the quality and quantity of work processed.
  • Monitors and evaluates monthly insurance reimbursement compliance and budgets.
  • Maintains and updates lists of insurance carriers and employers.
  • Solves difficult insurance claims problems.
  • Responsible for follow-up on unpaid claims and collections of unpaid balances.
  • Acts as resource to physicians, administrator and others, regarding health insurance claim policies and procedures for all types of insurance plans.
  • Supervises, trains and orients assigned personnel. Evaluates performance and recommends merit increases, promotions, and disciplinary actions.
  • Initiates and answers pertinent correspondence. Prepares and writes reports. Maintains required records and files.
  • Maintains knowledge of and complies with established policies and supplies.
  • Attends required meetings and participates in committees as requested and participates in professional development activities.
  • Evaluates patient financial status and established budget payment plans.
  • Works with patients and staff to resolve payment problems.
  • Performs related work as required.