Billing Follow-Up, CRMG

Essential Duties and Responsibilities

These duties and responsibilities described below represent the general tasks performed on a daily basis; other tasks may be assigned.

• Submit Inpatient/Outpatient electronic and paper claims (UB-04 and 1500) to the appropriate government and non-government payers.
• Understand how to resolve Billing errors and/or warnings that are identified in the Patient Accounting and Billing System.
• Keep abreast of payer-specific and government requirements and regulations.
• Ensures claim information is complete and accurate in order to accelerate cash collections.
• Analyze information contained within the Patient Accounting and Billing system to make decisions on how to proceed with the billing of an account.
• Processes rejections by correcting any billing error and resubmitting claims to government and non-government payers.
• Place unbillable claims on hold and properly communicate to various Hospital departments the information needed to accurately bill.
• Process late charge claims in the event that charges are not entered in a timely fashion by Hospital Departments.
• Submit corrected claims in the event that the original claim information has changed for various reasons.
• Perform the billing of complex scenarios such as interim, self-audit, combined, and split billing etc.
• Limit the number of unreleased claims by reviewing all imported claims and either billing or holding the claim for further review.
• Meet Billing productivity and quality requirements as developed by Leadership.
• Measured on high production levels, quality of work output, in compliance with established CRH’s policy and standards.
• Record or generate revenue by gathering and processing information that impacts the patient revenue process.
• Review patient financial records and/or claims prior to submission to ensure payer-specific requirements are met.