Primary Function

Responsible for submitting accurate, clean claims to third parties and private pay accounts, collecting and posting payments to patients accounts and following up on unpaid/incorrectly paid claims through to resolution of claim.

Responsibilities

• Register all new patients into computer system, ensuring that all necessary information is added to system.
• Analyze physician order/certificate of medical necessity/prescription submitted by physician for proper documentation of item ordered to ensure compliance with insurance billing regulations. Obtain additional information from physician office, when necessary.
• Track and obtain renewal of physician order/CMN for recurrent orders as necessary.
• Prepare patient charges for billing.
• Review claims for accuracy prior to submitting claims to proper party for payment.
• Review all payments made for accuracy and post all payments to patient accounts and adjust accounts accordingly.
• Analyze all incorrect payments and denied claims and resubmit with additional information as necessary.
• Use aging reports to track and follow-up unpaid claims and resubmit with additional information as necessary.
• Perform a variety of typing and clerical skills in relation to above duties.
• Performs all other related duties as assigned.

Job Qualifications and Specifications:

A High School diploma and a minimum of one year job-related experience or equivalent is required.

Care New England Health System (CNE) and its member institutions—Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group, and our Wellness Center—are trusted organizations fueling the latest advances in medical research, attracting the nation’s top specialty-trained doctors, and honing renowned services and innovative programs to engage in the important discussions people need to have about their health.

Americans with Disability Act Statement: External and internal applicants, as well as position incumbents who become disabled must be able to perform the essential job-specific functions either unaided or with the assistance of a reasonable accommodation, to be determined by the organization on a case-by-case basis.

EEOC Statement: Care New England is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status

Ethics Statement: Employee conducts himself/herself consistent with the ethical standards of the organization including, but not limited to hospital policy, mission, vision, and values.