Patient Acctg Govt. Specialist

External•Brooklyn, NY

5d•$32•Onsite

About The Position

This position is responsible for billing government accounts within twenty-four (24) hours of bill drop. The specialist will daily review billing reports and make necessary corrections in the electronic billing system and Meditech. They will collaborate with various departments such as Medical Records, Utilization Management, Patient Access, clinics, as well as with guarantors, physicians, and others to obtain and clarify required billing data that may cause errors in DDE and the billing system. The role involves establishing adequate follow-up dates to ensure timely account resolution and prompt payment on claims. All billing and follow-up activities must be clearly and effectively documented in the Meditech system. The specialist will also request and send any additional information and/or medical records needed to process claims for payment and work correspondence within forty-eight (48) hours of receipt, taking necessary actions to ensure claims are paid. A key responsibility is ensuring the Hospital's compliance with all state and federal rules and regulations, reporting any suspected compliance issues to the manager. The role includes daily work on Medicare's 72-hour rule report and Medicaid's APG reports to combine accounts as required, and processing outlier accounts when assigned. Additionally, the specialist will identify and process outliers, short stays, and long stay accounts, and perform other duties as assigned. They will review Medicaid and Medicare worksheets and remittance advices to identify variances between DRG and outstanding balance due.

Requirements

Understanding of APGs and clinic billings.
Minimum formal education of High School Diploma or equivalent.

Responsibilities

Bills government accounts within twenty-four (24) hours of bill drop.
Daily reviews billing reports and makes necessary corrections in the electronic billing system as well as in Meditech.
Works with Medical Records, Utilization Management, Patient Access, clinics, guarantor, physician, etc. to obtain and/or clarify required billing data that errors out in DDE and billing system.
Establishes adequate follow-up dates so that accounts are worked timely to ensure prompt payment on claims.
Documents all billing and follow-up activities in the Meditech system in a clear and effective manner.
Requests and sends any additional information and/or medical records needed to process claims for payment.
Works correspondence with forty-eight (48) hours of receipts, taking whatever action may be necessary to get claims paid.
Ensures the Hospital is in compliance with all state and federal rules and regulations and reports any suspected compliance issues to manager.
Works the Medicare's 72 hour rule report daily and Medicaid's APG reports to combine accounts as required.
Processes outlier accounts when assigned.
Identifies and processes outliers, short stays and long stay accounts.
Performs other duties as assigned.
Reviews Medicaid and Medicare worksheets and remittance advises to identify variances between DRG and outstanding balance due.