PHYSICIAN OUT OF NETWORK COLLECTIONS
Apply NowCompany: Hudson Regional Hospital
Location: Secaucus, NJ 07094
Description:
- Be able to process primarily out of network physician claims for Spine and other specialties including Orthopedic and Pain Management
- Ability to work well independently and communicate efficiently and respectfully with patients and insurance representatives.
- Process out of network claim types.
-Identify billing errors and denials, by understanding the problem and resubmit corrected claims or take other appropriate action to resolution.
-Negotiate out of network reimbursement, based on determined criteria for maximum eligible reimbursement.
-Send appeals for: low reimbursement, no authorizations, timely filing, medical necessity etc. with correct documentation.
-Submit paper claims to primary and secondary insurance with correct documentation, ie: operative reports, implant invoices, primary eob's.
-Adjust claims for correct fee schedule, incorrect payments and patient responsibility.
- Scan work and correspondence daily and maintain clear detailed notes.
Education/Experience Requirements
Coding or Billing Certification preferred but not required
Minimum 5 years Billing/Collections experience
High school diploma/GED
Workers Compensation (NY and NJ) and No Fault/PIP (NY and NJ) Billing and Follow-up Experience is a plus
- Ability to work well independently and communicate efficiently and respectfully with patients and insurance representatives.
- Process out of network claim types.
-Identify billing errors and denials, by understanding the problem and resubmit corrected claims or take other appropriate action to resolution.
-Negotiate out of network reimbursement, based on determined criteria for maximum eligible reimbursement.
-Send appeals for: low reimbursement, no authorizations, timely filing, medical necessity etc. with correct documentation.
-Submit paper claims to primary and secondary insurance with correct documentation, ie: operative reports, implant invoices, primary eob's.
-Adjust claims for correct fee schedule, incorrect payments and patient responsibility.
- Scan work and correspondence daily and maintain clear detailed notes.
Education/Experience Requirements
Coding or Billing Certification preferred but not required
Minimum 5 years Billing/Collections experience
High school diploma/GED
Workers Compensation (NY and NJ) and No Fault/PIP (NY and NJ) Billing and Follow-up Experience is a plus