Maintains compliance with established processes, and achieves section/organization quality goals.
Knowledgeable in Revenue Cycle Management registration, and use of multiple information systems to accurately select, and submit appropriate information.
Accurately performs, verifies, and evaluates appropriateness on patient demographic, and insurance information.
Prioritizes, and organizes work to facilitate the timely, and accurate completion of multiple tasks simultaneously by assessing the urgency of the tasks, and the time required to complete them.
Identifies problems, and initiates immediate follow-up as necessary with the Manager, Service Leader, or Medical Director(s) to ensure accurate, timely laboratory services by using critical thinking skills, and decisive judgment.
Accommodates patient, and laboratory needs by professionally responding to requests for flexibility in duties, schedules, and staffing.
Maintains section materials, supplies, and equipment by following section policies.
Bills and posts charges, prepares and posts manual charges, and follows up on denial reports and problem resolution.
Reviews and verifies assigned codes, and sequences diagnosis and procedures according to regulations.
Contacts Physicians or Clinics for clarification of clinical information as appropriate for account type as necessary.
Maintains up to date knowledge of coding, and regulatory requirements to accurately determine if coding is appropriate for reimbursement of healthcare services.
Utilizes web based tools, coding books, and other available resources to provide insurance companies with required information.
Participates, and assists with audits to capture lost revenue, and determine accuracy of billing as necessary.
Ensures all payer sources, commercial and governmental, are verified eligible.
Utilizes online systems to gain needed information for notification, and pre-certification as needed.