· Timely follow-up on hospital patient accounts that are outstanding for insurance payment, including but not limited to the following processes: verify claim payment status, rebill to patient’s insurance, proration to correct financial class and notation within patient accounts providing steps taken to resolve outstanding insurance balance on account.
· Work an average of 30-40 patient accounts per workday for assigned payor(s)
· Manages an average of 30-40 patient accounts per day, focusing on denial and zero-pay reporting.
· Assigned Payor denials and Zero ($0) pay reports worked within 48 hours of receipt
· Communicate effectively with insurance companies for payment of outstanding insurance balances, understanding of next steps needed to reach resolution of outstanding insurance balance
· Perform research on patient accounts with outstanding insurance balances and route patient accounts through appropriate workflows
· Responsible for resolving patient accounts with outstanding insurance claims to a zero balance or advancing them to the patient responsibility financial class.
· Performs account follow-up on unpaid or partially paid insurance claims for hospital services.
· Contacts insurance payors through various methods, including telephone calls, Insurance payor web portals, E-faxing, email
· Investigates the cause of non-payment towards outstanding hospital claims and takes appropriate actions such as: Requesting insurance companies to process claims, requesting cash posting review for corrections, initiating coding reviews for account resolution, contacting patient for insurance information
· Completes adjustment requests for Team Lead approval if an adjustment to the outstanding balance
· Submits requests for claim rebilling when additional information is required, using either a shared spreadsheet or the EHR system. Utilizes MEDTEAM’s ticketing system to submit claim inquiry requests if additional information or review from the hospital is required.
What We Do
For over 25 years, Harris Healthcare has been rising to the challenge of bringing together the most innovative and sustainable solutions for today’s ever-changing healthcare environment, in order to improve patient care and safety. Each one of our solutions brings organizational efficiencies on its own. Powerful synergies are achieved when multiple solutions are implemented together. The Harris Healthcare portfolio includes the following solutions:
♦ HARRIS Flex - an enterprise-level EHR solution that improves patient safety and clinical workflows. It includes a full complement of applications integrated in one single database, provides solid clinical decision support to your clinicians and helps standardize care while enforcing protocols and best practices at any Healthcare Organization. HARRIS Flex conveys the digital solution’s flexibility and strength.
Healthcare organizations are continuously faced with new challenges and situations and require flexible EHR’s that can be rapidly adapted to their evolving clinical practice. Contrary to other EHR solutions which are inflexible and where customizations require costly support from the vendor, HARRIS Flex gives you the freedom to "flex" your EHR as you need it entirely on your own.
The enhanced HARRIS Flex solution comes with new functionality including:
♦Flex Telehealth which enables virtual visits directly from within the EHR/EPR, and
♦Flex Clinical Insight which facilitates extraction and analysis of your EHR/EPR data to improve your processes and outcomes.
♦ SynergyCheck – a proactive interface monitoring solution watching over Clinical, Financial and other interfaces 24/7 to ensure data is flowing between systems
