Insurance & Medical Records Clerk

Description

Summary:

Responsible for obtaining signed orders from physicians per state regulations. Manages and maintains the integrity of the home care patient medical records to include tracking and timeliness of physician orders to meet regulatory requirements. Runs daily physician order runs for mailing. Assists with the eligibility, authorization and billing process. Provides back-up coverage of the reception desk in the absence of the receptionist and back-up for the schedulers.

Responsibilities

• Maintains the integrity of the home care patient medical records to include tracking and timeliness of physician orders to meet regulatory requirements, running daily physician order runs for mailing/faxing, and maintains confidentiality and safety of patient medical records and information.
• Print reports for outstanding orders, follow-up with physician offices re: re-printing and/or re-faxing of orders to comply with State of CT Regulations.
• Reviews and enters patient/client registrations as submitted. Ensures proper pay status, ID numbers, social security numbers, diagnoses codes, and physicians are entered in the computer to generate billing.
• Conducts insurance verification/authorization process.
• Review and prepare patient billing, per guidelines established by payor. Prepares bills, copies all forms to be sent with bills, follow-up with billing adjustments and co-pays to individual patients. Checks paid bills against files to determine collection action.
• Processes phone calls from patients or patient representatives and supply billing and payment information requested.
• Performs collection activities for payors.
• Cover scheduling position when staff is out and/or on vacation.
• Cover intake assistant duties when staff is out and/or on vacation.
• Provides back-up coverage of telephone for the reception area.
• Participates in weekend rotation for insurance eligibility and authorization.
• Fulfills all compliance responsibilities as related to the position.
• Maintain and Model Nuvance Health Foundational Values (Personal, Imaginative, Agile, Connected.
• Performs other duties as required.
  
  

Working Conditions

Manual: significant manual skills/motor coord & finger dexterity

Occupational: Little or no potential for occupational risk

Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force

Physical Environment: Generally pleasant working conditions

Company: Western CT Home Care Inc

Org Unit: 617

Department: Financial

Exempt: No

Salary Range: $17.60 - $33.48 Hourly