Location(s): OSU Physicians Corporate (700 Ackerman Road, Columbus)
Uses intermediate knowledge of invoices, claims, insurance/Medicare billing, collections, and medical terminology in order to complete multiple tasks related to insurance billing. Act as a liaison between the physician, insurance companies, and third parties by processing and verifying invoices, ensuring payment of claims, and reviewing insurance reimbursements. Updates and resolves patient accounts for billing, evaluates patient financial resources, and establishes payment terms. This position will perform the full range of duties, and may do so on a rotational or specialization basis of assignment.
Requirements: High school diploma or equivalent, at least two or more years of claims processing, insurance billing, and/or medical terminology experience or training; or equivalent combination of education and experience. Ability to communicate both in writing and verbally. Experience with a computerized billing system. High level of interpersonal skills to handle sensitive and confidential situations; demonstrated poise, tact and diplomacy.
Duties and Responsibilities:
Reviews, verifies, obtains and corrects patient demographics and insurance information, medical diagnosis, laboratory and other diagnostic services information, hospital service, applicable dates, required authorizations and certifications, signatures, and other information related to preparation and processing of insurance bills, and eligibility of coverage.
Researches and resolves missing or conflicting patient information.
Coordinates and analyzes EOB’s for denials and irregularities, institutes appropriate actions, and reprocess claims in accordance with Company policy.
Requests completion of additional forms or information for denied claims or special processing requirements.
Reconciles accounts; adjusts balances to reflect denials, adjustments, payments, and other modifications to balances.
Updates work files and invoices utilizing system-generated reports.
Develops and maintains favorable relationships with new and existing payors in order to increase awareness and revenue.
Attends regular compliance and billing training seminars.
Attendance, promptness, professionalism, the ability to pay attention to detail, cooperativeness with co-workers and supervisors, and politeness to customers, vendors, and patients.
Other duties or special projects as assigned.