Website Cancer Centers of Southwest Oklahoma

DEFINITION:  

Under the direction of the business office manager, the billing representative is responsible for the daily processing of insurance claims, posting of monies received by insurance companies and patients and monthly follow up of accounts receivable.

PREFERRED QUALIFICATIONS:
Basic computer skills
Must have good organizational skills, reading, writing and proven communication skills.
Two years billing experience in a hospital or clinic setting.

PRINCIPLE RESPONSIBILITIES:

1. Process and balance all monies received.
1.1. Review all incoming insurance payments to ensure payment is accurate according to the company fee schedule.
1.2. Batch and post all monies received from insurance companies.
1.3. Batch and post all monies received from patients.
1.4. Prepare daily deposits.
1.5. Appeal underpayments with insurance companies by calling, writing or faxing the claims department.
1.6. File and date stamp all Explanation of Benefits processed.
1.7. Download Medicare Remittance Advice Reports daily.
1.8. Notify the business office manager of any trends in problems or underpayments.

2. Transmit primary and secondary claims to clearinghouse.
2.1. Transit claims in Mosaiq to create claim files.
2.2. Upload claim files to clearinghouse website.
2.3. Ensure claim acceptance.
2.4. Download any 997 files and process in Mosaiq.
2.5. Move claim files on groups drive to Sent file folders.

3. Work the Accounts Receivable list monthly.
3.1. Call insurance companies to check status of outstanding claims.
3.2. Resubmit claim forms as needed.

4. Enter all hospital evaluation and management charges.
4.1. Obtain patient demographics from hospital if not in our system.
4.2. Enter patient charges. Tag, review and post charges accurately.
4.3. Notify physician of any missing charges.

5. Obtain purchase orders and certificates of medical necessity.
5.1. Coordinate with Lawton Indian Hospital to obtain purchase orders for claims.
5.2. Complete Certificates of Medical Necessity forms for Durable Medical Equipment Rentals.

6. Respond to all insurance correspondence.
6.1. Provide medical records when requested by insurance companies.

7. Answer billing questions.
7.1. Answer patient questions regarding their bill.
7.2. Provide EOB’s to patients if they do not understand their balance.

 

To apply for this job please visit www.ccswok.com.