Northwell Health Senior Clinical Practice Plan Representative in Melville, New York

Req Number 001H0O

Job Category Billing Clerical

Job Description

Assures that patients understand their financial obligation to pay for medical services rendered. Obtains all necessary information and enters it into the billing system for timely and accurate billing and collection.

Responsibilities Include:

  • Registers/re-registers patients. Reviews registration forms for completeness and accuracy of data and performs data entry. Updates insurance information obtained by Hospital registrars.

  • Verifies insurance coverage for elective surgeries, high dollar services, and patients with on-going courses of treatment.

  • Notifies patient and arranges for alternative payment methods when insurance coverage does not cover services/courses of treatment.

  • Collects point of service payments, as appropriate.

  • Arranges budget plans in accordance with CPP criteria.

  • Prepares batches and performs data entry for charges, registration information and payment information.

  • Verifies that batches received from billing areas are in balance on a daily basis. Researches and resolves any discrepancies.

  • Performs point of service account follow-up for all patients seen in hospital.

  • Prepares payment transmittals for point of service and mail payments, as received.

  • Answers on-site patient inquiries regarding account or payment status for all practices at the hospital.

  • Responds to third-party request for information/documentation.

  • Answers physician inquiries regarding specific accounts.

  • Documents results of insurance verification, financial counseling, responses to information requests and other appropriate activities on IDX.

  • Performs related duties, as required.

Qualifications

  • High School Diploma or equivalent, required.

  • Minimum of three (3) years professional billing experience, in related specialty.

  • Knowledge of Federal, State and third-party reimbursement rules and regulations. Knowledge of medical terminology, required.

  • Knowledge of IDX system, preferred.

  • Ability to communicate effectively.