Work Schedule:

Coordinates all patient, client and insurance billings for the medical facility.  Maintains detailed knowledge and application of billing requirements for third party payors.  Processes insurance payments to patients’ accounts and works to coordinate information on these accounts through communication with providers and patients.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following.  Other duties may be assigned.

• Maintains detailed knowledge of billing requirements and rules for third party payors.
• Assures all financial and demographic information is correct and complete.
• Assures that all allowances, discounts, co-payments are applied properly.
• Processes insurance payments to patient accounts in computerized system.
• Obtain prior authorization and perform patient benefit investigations.
• Contact accounts, physician, or patient to obtain any missing information needed to accomplish accurate billing records.
• Accepts additional responsibilities during staffing shortages.
• Re-bills insurance companies or other third parties to secure payment for patients.
• Assists with the training of appropriate personnel on computerized billing system.
• Maintains knowledge of and adheres to the department’s Standard Operating Procedures (SOP’s).
• Responds to patient/client billing and statement inquires through phone or mail correspondence.
• Obtains and mails invoice copies for customers, as requested.
• Researches and processes customer claims of invoice payment.
• Answers accounts receivable phone inquiries and follows up with patient/client.
• Identifies overpayment by insurance companies or patients and issues refund request forms to Supervisor. 
• Investigates insurance denials as necessary for maximum reimbursement.

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education/Experience:

High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience.

Language Ability:

Ability to read and comprehend simple instructions, short correspondence and memos.  Ability to write simple correspondence.  Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.

Math Ability:

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions and decimals.  Ability to compute rate, ratio and percent and to draw and interpret bar graphs.

Reasoning Ability:

Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.  Ability to deal with problems involving several concrete variables in standardized situations.

Computer Skills:

Basic computer skills (windows, medical record software, MS Office, etc.) with proficient data entry skills of 40-50 wpm, in addition to basic knowledge of standard office equipment.

Certificates and Licenses:

No certifications required.

HNL Lab Medicine is an equal opportunity employer. In accordance with, and where applicable, in addition to federal, state and local employment regulations, Lehigh Valley Health Network will provide employment opportunities to all persons without regard to race, color, religion, sex, age, national origin, sexual orientation, gender identity, disability or other such protected classes as may be defined by law. All personnel actions and programs will adhere to this policy. Personnel actions and programs include, but are not limited to recruitment, selection, hiring, transfers, promotions, terminations, compensation, benefits, educational programs and/or social activities.

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