• Submits all clean claims to the appropriate insurance payer the same day as the claim is loaded into the Editor with the exception of weekends.
• Reviews payer EOB?s but not limited to payment accuracy, patient liability, and appeal grievances if applicable.
• Files appeals on denied claims and/or forwards to the Nurse Auditor for review if applicable
• Maintain better than an 80% clean claim average.
• Attach but not limited to the medical records, implant invoices, and itemized bill to the claim when applicable
• Process incoming mail correspondence from the payers within 5 business days
• Work assigned billing reports within 2 business days
• Follow up with the insurance companies by phone and or web for the status of outstanding claims if applicable
• Respond to patient inquiries regarding the status of the patient?s insurance within 2 business days
• Submit newborn notifications to income support if applicable 
• Review/resolve the accounts on the Unbilled Report daily (accounts that are on hold and haven?t been processed by the editor).
• Enter detailed notes explaining account activity in the Patient Accounts system
• Take payments over the phone.
• Print UB and 1500 hardcopy claims when required by the payer
• Bill secondary claims before the timely filing deadline
• Research late charges to determine the cause; inform your supervisor if they are a regular occurrence.

• Handle incoming correspondence and inquiries on accounts.
• Report trends/issues to Supervisor and the Director of Patient Financial Services
• Follow up with all insurance companies within 30 days of billing if there is no payment on the account if applicable
• Forward patient complaints regarding care to your supervisor for entry into the appropriate resolution pathway

Education

Required:

    High School

Licenses & Certifications

Preferred:

    C-Heartsaver

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About CHRISTUS Health

CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.

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