Review medical records and assign appropriate codes (e.g., CPT, ICD) to procedures and diagnoses.
Ensure accurate and complete documentation for each claim submission.
Verify insurance coverage and eligibility for patients.
Prepare and submit claims to insurance companies and other third-party payers.
Generate accurate and detailed billing statements for patients.
Track and monitor the status of submitted claims.
Follow up on denials, rejections, and unpaid claims.
Initiate collection efforts or establish payment plans for outstanding balances.
Communicate with insurance companies to verify coverage and obtain pre-authorization for procedures.
Gather necessary information and documentation for billing purposes.
Ensure compliance with insurance policies and guidelines.
Reconcile payments received with billed amounts.
Update patient accounts and records with payment information.
Investigate and resolve discrepancies or unpaid balances.
Process refunds or adjustments as necessary.
- Compliance and Documentation:
Stay up to date with relevant healthcare laws, regulations, and coding guidelines.
Ensure compliance with HIPAA regulations and maintain patient privacy and confidentiality.
Maintain accurate and organized records of billed services, claims, payments, and communication.
- Communication and Customer Service:
Respond to inquiries from patients, insurance companies, and healthcare providers regarding billing issues, insurance coverage, and payment options.
Provide excellent customer service while addressing concerns and resolving billing-related matters.