The Facility Contracts Representative is responsible to follow up with contracted facilities and patients transported as a result of a contract. Handles all aspects of billing the facilities, inclusive of following up and collections.
- Initial billing of HMO, Kaiser/Group Health Cooperative (GHC), multiple state facilities and/or financial classes.
- Ability to determine and enter appropriate contract code into Accounts Receivable Billing System.
- Work correspondence received from patients, facilities, contracts, commercial insurance carriers, government payors, (e.g. denials, appeals, requested information, account status).
- Note account with trip comments, follow up and then forward to collection plan for review and processing. The contract follow-up database will be used to note facility billing and follow up activity.
- Search for multiple trips taken on the same date of service.
- Review, print and mail facility invoices on a daily, weekly or monthly basis based on the terms of the Contract.
- Update Facility Diary with billed dates.
- Establish and maintain hard copy and electronic files for each facility.
- Compile data on each facility and maintain corresponding spreadsheets. Process and maintain facility reports and records.
- Ensure proper processing of partial payments by reviewing the Explanation of Benefits (EOB) to ensure all charges have been processed and paid correctly prior to balance billing patient or processing write off.
- Review “Error”, “Stalled Trip”, and “Invoices Not Printed” reports to identify errors that prevent a claim from being processed. Correct errors and notify management daily.
- Telephone facilities regarding obtaining payment for all delinquent accounts.
- Mail certified letters, (e.g. demand letters and pre-collection notices) to facilities.
- Attend, prepare, and present data at client meetings.
- Perform other duties as required; Assist in special insurance claim AR projects and answer overflow/provider calls as needed.
- High School Diploma or GED required; Associates Degree or technical certification in coding and billing preferred.
- One (1) year billing experience required.
- Understanding of medical transportation processes, medical terminology and insurance terminology, language and terminology on a pcr, hospital face sheet, and/or a cad sheet, and hipaa requirements.
- Working knowledge of payor-specific requirements for multiple state facilities and/or financial classes.
- Working knowledge of contracts and comprehension of contract fact sheets (contract terms, rates, billing address, timely filing terms, etc.); understand the process of signature and paperwork compliance.
- Knowledge of definitions of and distinctions between als/bls/sct/wheelchair levels of service; ICD-9 coding/condition codes and procedure codes.
- Proficiency in the accounts receivable billing system and internet tools, e.g. internet mapping programs, eligibility websites, address search engines.
Integra Connect, LLC provides a comprehensive benefits plan.
- Medical/Dental/Vision Insurance beginning the 1st of the month following your date of hire
- Paid Time Off
- 401k with employer match
- Paid Holidays and Floating Holiday
Equal Opportunity Employer
|Job Category||Revenue Cycle Solutions Management|