Performs necessary clerical tasks to expedite the initiation/continuation of outpatient billing. Participates in quality assessment and continuous quality improvement activities. Performs all job duties and responsibilities in a courteous and customer-focused manner according to the Hurley Family Standards of Behavior.Works under the direct supervision of a departmental director or designee who reviews work for conformance to established policies and procedures.

• High school diploma or equivalent.
• One (1) year of experience in responsible office work, preferably with close interaction with third party payers and physicians.
• Working knowledge of medical terminology and procedures.
• Working knowledge of billing procedures and requirements.
• Demonstrated positive working relations with physicians, third party payers, medical records, and other medical center personnel.
• Ability to work independently and make decisions in accordance with established policies and procedures.
• Ability to maintain effective working relationships with supervisors, coworkers, other Medical Center, employees, vendors, and the public.

1. With input from appropriate staff, completes/types patient prior authorization forms as required by various payors for initiation/continuation of services.
2. Ensures timely processing of third party paperwork; e.g., Medicare/Medicaid, managed care and commercial insurance prior authorizations, worker's compensation authorizations, Hill-Burton approvals and physician referrals.
3. Maintains accurate, patient-specific log of reimbursement documentation. Conveys reimbursement/billing documentation to appropriate staff members in timely manner.
4. Contacts appropriate medical departments to acquire necessary information to verify financial responsibility of patients receiving outpatient services.
5. Obtains third party authorization numbers as required by various insurers. Documents information in patient records according to departmental policies and standards.
6. Confers with state and local agencies, third party payers, managed care providers, and internal sources to verify patient information and insurance coverage.
7. Works with health information systems and therapy staff to obtain supportive clinical documentation for third party payers when requested.
8. Responds to telephone and mail inquiries relating to patient billing. Acts as a liaison between patients, third party payers, physicians, therapy staff, and other Medical Center departments with regard to billing issues.
9. Assists with registration of patients into computerized information system. Captures demographic, insurance, and other information to ensure accurate and timely reimbursement.
10. Maintains accurate, current departmental insurance manuals including timely dissemination of third-party payer information to staff.
11. Operates office equipment, including computers, typewriters, copiers, fax machines, and other information processing equipment.