Process patient account payments, update insurance and demographic information, research payments, rebill insurance, and follow up on outstanding accounts. Answer billing calls, explain bills, collect patient payments, and collaborate with other departments to resolve account issues accurately and promptly.
The Patient Health Benefits Counselor determines patient eligibility for financial programs and verifies insurance coverage for scheduled procedures. They act as a liaison between patients, medical staff, and billing entities to ensure accurate documentation and payment collection.
The ED Coder is responsible for the accurate coding and abstracting of outpatient records using ICD-10-CM and CPT systems. They ensure billing accuracy, resolve coding edits, and maintain compliance with regulatory guidelines and organizational policies.
Lead the design, implementation, and oversight of regional Utilization Management programs, including admission and continued-stay reviews, retrospective authorizations, appeals, and denial management. Direct staff and collaborate with clinical, revenue cycle, payer strategy, and organizational leaders to ensure regulatory compliance, improve utilization and financial outcomes, and report trends and program performance.
The Scheduler/Pre-Registrar manages incoming calls and faxes to schedule outpatient tests while ensuring accurate pre-registration of patients. They are responsible for verifying insurance eligibility and maintaining an up-to-date scheduling system.
The Hospital Surgery/Observation Coder is responsible for accurately coding and abstracting outpatient surgical and observation records for reimbursement and research. They must ensure all coding meets quality and productivity standards while effectively navigating EMR systems and resolving coding edits.
The Coding Auditor & Educator performs internal audits, monitors regulatory changes, and provides coding guidance to staff. They are responsible for onboarding new employees, delivering educational feedback, and identifying documentation improvement opportunities.
