Medicare Billing for Franciscan hospitals

Ensure complete, accurate and timely electronic and paper billing of insurance claims daily by: researching and resolving claim edits; checking that the claim is complete and correct; where required, checking patient eligibility with payors and verifying that patients have been assigned a HIC number with Medicare, where required ensuring the HIC number are correctly added to patient accounts to ensure prober billing; and checking that all other billing and documentation requirements are met.Research and complete pended or denied claims as appropriate.Working daily WIP claims follow-up accounts: reconciling balances, identifying and resolving any issues and completing on time and to standard.Place claim with facility data integrity and system errors promptly onto facility WIP for correction, appeal or authorization for write-off and working the claim on time when returned.Submit complete documentation, on time, for denials and/or appeals.Apply late charges and credits to the claim and submit documentation timely and accurately utilizing the SSI Click-On Billing system. Research the account in Host system, Meditech, and account maintenance software, CUBS, and determine whether it is appropriate to re-bill or write-off.Identify research and resolve issues that impede successful electronic and paper billing.Accurately, clearly and professionally document in the Account Maintenance Software all account changes, updates, and/or instructions for account resolution to ensure proper records are maintained. As needed, maintain up to date knowledge base of Medicare policies and procedures as well as Federal, State and local laws, regulations and other requirements. Comply with all applicable Federal, State, and local laws, regulations, and requirements.Maintain confidentiality of all patient demographic, medical, and financial information. Maintain confidentiality of all revenue cycle and client information.

Contact insurance companies to resolve outstanding accounts.Identify and resolve issues associated with a claim denial or payment delay.Move accounts to appropriate support desks relative to billing, medical records and utililzation review issues as needed.Work accounts in order of priority as required in CUBS WIP each working day.Identify ongoing payor issues and clearly articulate them to insurers.Write and submit accurate appeals, including all necessary supporting documentation.Work with providers to obtain referrals for necessary accounts.Coordinate write-offs with appropriate leadership team members.Utilize eligibility systems to determine correct eligibility when needed.Contact various payors as needed to verify or obtain information.Communicate professionally and effectively with internal and external contacts.Maintain accurate, clear, concise and complete account information in CUBS.Assist with training of new employees and promoted teamwork amongst departments.Comply with all applicable Federal, State and local laws, regulations, and requirements as well as business policies and procedures of job performance.Maintain confidentiality of all patient demographics, medical and financial information at all times. Maintain confidentiality of all company and client information. Ensure proper handling and disposal of confidential documents and adheres to all HIPPAA rules and regulations.